Individual provider Active NPI

Christopher Shin, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Murrieta, CA
National Provider Identifier
1053422253
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4623 Issued in CA
Practice address
39755 Murrieta Hot Springs Rd
Suite D - 130
Murrieta, CA 92563-9101
Phone
(951) 698-4611
Fax
(951) 698-4615
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4623 CA Primary

Addresses

Primary practice location

39755 Murrieta Hot Springs Rd
Suite D - 130
Murrieta, CA 92563-9101

Mailing address

39755 Murrieta Hot Springs Rd
Ste D130
Murrieta, CA 92563-9110
Phone (951) 674-7223

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809000443 CA Practitioner - Podiatry 2264461326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empire Podiatry IncGroup PAC ID 2264845791, 6 clinicians

Practice addresses (Care Compare)

24640 Jefferson Ave
Suite 109
Murrieta, CA 92562-9027
Phone (951) 677-1323

Hospital & facility affiliations

  • Southwest Healthcare Rancho Springs Hospital Hospital, Murrieta, CA, CCN 050701

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue30
Removal of skin lesions26
Removal of nail tissue574
Removal or shaving of skin growth239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4623CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Podiatry, Inc Foot & Ankle Surgery CurrentSince Jan 1, 2021 Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Regal Medical Group, Inc. Past Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients

Locations

24640 Jefferson Ave
Ste 109
Murrieta, CA 92562
Phone (909) 677-1323

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1053422253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39755 MURRIETA HOT SPRINGS RD",
            "address_2": "STE D130",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925639110",
            "telephone_number": "951-674-7223",
            "fax_number": "951-698-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39755 MURRIETA HOT SPRINGS RD",
            "address_2": "SUITE D - 130",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925639101",
            "telephone_number": "951-698-4611",
            "fax_number": "951-698-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.