Active NPI
William Woosik Shin, MD
- Pediatrics Physician
- Flushing, NY
National Provider Identifier
1053461236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 222692
- Practice address
- 4221 162ND St
#1B
Flushing, NY 11358-4150 - Phone
- (718) 463-0101
- Fax
- (718) 460-2009
- NPI assigned
- Jan 11, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 222692 | NY | Primary |
Addresses
Primary practice location
4221 162ND St
#1B
Flushing, NY 11358-4150
Mailing address
42-21 162 St
Flushing, NY 11358
Phone (718) 463-0101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02203249 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 222692 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physicians Group P C | Pediatrics | Past | Accepting new patients |
| Beth Israel Medical Center | Pediatrics | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Organizations & group practices 2
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.
-
- General Practice Physician
- Staten Island, NY
- NPI 1104872134
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1053461236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42-21 162 ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11358",
"telephone_number": "718-463-0101",
"fax_number": "718-460-2009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4221 162ND ST",
"address_2": "#1B",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113584150",
"telephone_number": "718-463-0101",
"fax_number": "718-460-2009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "WILLIAM",
"middle_name": "WOOSIK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "222692",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02203249",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.