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Jonathan Andrew Lim

Internal Medicine

Allopathic & Osteopathic Physicians

65 Burbank St, Apt 21, Boston, MA 02115-3629

PECOS Enrollment

This provider is enrolled in PECOS as JONATHAN LIM.

Based on the most recent information from CMS, provider Jonathan Andrew Lim is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1730566548
Provider Type
Individual
Full Name
Lim, Jonathan Andrew
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/30/2015
Last Updated
4/30/2015

Contact Information

Practice Location

65 Burbank St, Apt 21, Boston, MA 02115-3629

(636) 399-7157

Unlisted Fax

Mailing Location

65 Burbank St, Apt 21, Boston, MA 02115-3629

(636) 399-7157

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License BP10052913 Texas

Jonathan Andrew Lim

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Hwang, Catherine

David, John R

Britton, Oneil A

Campion, Edward W

Katz, Ingrid T

Massicott, Peter J.

Hardenstine, Rachel

Gandhi, Tejal K

Chin, William W

Woo, Beverly