Active NPI
Caroline Shim, MD
- Pediatrics Physician
- Pacific Palisades, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A76783
- Practice address
- 881 Alma Real Dr Ste 316
Pacific Palisades, CA 90272-5061 - Phone
- (310) 454-2296
- Fax
- (310) 454-2295
- NPI assigned
- Feb 5, 2007
- Last updated
- Jan 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A76783 | CA | |
| Pediatrics Physician | 208000000X | A76783 | CA | Primary |
Addresses
Primary practice location
881 Alma Real Dr Ste 316
Pacific Palisades, CA 90272-5061
Mailing address
910 Via de la Paz
Suite 207
Pacific Palisades, CA 90272-3515
Phone (310) 454-4466
Other practice location 1
970 Monument St Ste 220
Pacific Palisades, CA 90272-3898
Phone (310) 454-2296
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cshim473199@oc.providencedirect.org | ||
| Direct Messaging Address | cshim473199@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A76783 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Saint Johns Medical Foundation | Specialist | Current | Accepting new patients |
| Providence Saint John's Health Center | Past | Accepting new patients | |
| Palisades Pediatrics | Specialist | Past | Accepting new patients |
Locations
12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640
881 Alma Real Dr
Ste 101
Pacific Palisades, CA 90272
Phone (310) 454-2296
970 Monument St
Ste 220
Pacific Palisades, CA 90272
Phone (310) 454-2296
881 Alma Real Dr
Ste 316
Pacific Plsds, CA 90272
Phone (310) 454-1317
2021 Santa Monica Blvd
Ste 245E
Santa Monica, CA 90404
Phone (310) 829-4403
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
2020 Santa Monica Blvd
Ste 300
Santa Monica, CA 90404
Phone (310) 582-7312
901 Wilshire Blvd
Fl 2
Santa Monica, CA 90401
Phone (310) 829-8908
2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Saint John's Physician Partners
- Specialist
- Santa Monica, CA
- NPI 1770093734
-
- Specialist
- Pacific Palisades, CA
- NPI 1689712358
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1124026273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1043359284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 VIA DE LA PAZ",
"address_2": "SUITE 207",
"city": "PACIFIC PALISADES",
"state": "CA",
"postal_code": "902723515",
"telephone_number": "310-454-4466",
"fax_number": "310-454-0916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "881 ALMA REAL DR STE 316",
"city": "PACIFIC PALISADES",
"state": "CA",
"postal_code": "902725061",
"telephone_number": "310-454-2296",
"fax_number": "310-454-2295"
}
],
"practiceLocations": [
{
"address_1": "970 Monument St Ste 220",
"address_purpose": "LOCATION",
"city": "Pacific Palisades",
"state": "CA",
"postal_code": "902723898",
"country_code": "US",
"telephone_number": "310-454-2296",
"fax_number": "310-454-2295",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIM",
"first_name": "CAROLINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A76783",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A76783",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cshim473199@oc.providencedirect.org",
"affiliation": "N",
"address_1": "881 Alma Real Dr Ste 101",
"city": "Pacific Palisades",
"state": "CA",
"country_code": "US",
"postal_code": "902723792",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cshim473199@oc.providencedirect.org",
"affiliation": "N",
"address_1": "881 Alma Real Dr Ste 316",
"city": "Pacific Palisades",
"state": "CA",
"country_code": "US",
"postal_code": "902725061",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Pacific Palisades, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.