Active NPI
Kichul Shin, MD, PHD
- Rheumatology Physician
- Boston, MA
National Provider Identifier
1023218724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 233363
- Practice address
- 45 Francis St
Boston, MA 02115-6105 - Phone
- (617) 525-1082
- NPI assigned
- Jul 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 233363 | MA | Primary |
Addresses
Primary practice location
45 Francis St
Boston, MA 02115-6105
Mailing address
1501 Beacon St
Apt 1503
Brookline, MA 02446-4626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 233363 | MA | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1023218724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 BEACON ST",
"address_2": "APT 1503",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156105",
"telephone_number": "617-525-1082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "KICHUL",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-20",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MA",
"license": "233363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.