Amanda Shin, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

295555 Issued in CA

Practice address

17270 Bear Valley Rd Ste 105
Victorville, CA 92395-7751

Phone

(760) 245-8828

NPI assigned

Jan 9, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amanda Ratner Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Loma Linda University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Surgical Specialists PCGroup PAC ID 4183527153, 118 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.shindpt.p1@direct.reboundmd.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Surgical Specialists, P.C.

  • Orthopaedic Surgery Physician
  • Portland, OR
  • NPI 1730118803

  WA

  Medicare reassignment Care Compare group NPD
• Northwest Surgical Specialists PC

  • Durable Medical Equipment & Medical Supplies
  • Vancouver, WA
  • NPI 1821510306
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1043783350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17270 BEAR VALLEY RD STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17270 BEAR VALLEY RD STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957751",
            "telephone_number": "760-245-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "AMANDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "295555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "RATNER",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sherylann Wade, M.D., Inc.
• Makoto Shibutani
• Shiloh Medical Center Inc
• Shima Hadidchi MD a Professional Corp
• Shima Hadidchi MD a Professional Corp
• Andrew Woochul Shin, D.D.S
• Hyun Joon Shin, DDS
• Young Shin, DPT
• Myunghee Shinpark, R.P.H.
• James Francis Shirey, LMFT

• Physical Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.