Peter Yong Seung Shin, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

306709 Issued in NY

Practice address

185 S Orange Ave
Newark, NJ 07103-2757

Phone

(973) 972-4300

NPI assigned

May 15, 2015

Last updated

Apr 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Rutgers New Jersey Medical School, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Nyc Medical Associates LLCGroup PAC ID 4385894237, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New York Community Hospital of Brooklyn, Inc. Hospital, Brooklyn, NY, CCN 330019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• United Nyc Medical Associates LLC

  • Anesthesiology Physician
  • Brooklyn, NY
  • NPI 1871844142
  Medicare reassignment Care Compare group NPD
• North Shore - Lij Anesthesiology, PC

  • Anesthesiology Physician
  • Chappaqua, NY
  • NPI 1417401266
  Medicare reassignment NPD

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

• New York Community Hospital of Brooklyn Inc

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1215030697
  Care Compare affiliation

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1073991626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 15TH ST APT 18E",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241935",
            "telephone_number": "201-978-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "PETER",
        "middle_name": "YONG SEUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-15",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "306709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Shilan, MD
• Shiloh Wellness
• Brandon Jaeyoon Shim, DDS
• Noa'a Shimoni, MD
• Jaewoo Shin, MD
• Shinbi Acupuncture Care, P.C.
• Shine on Mental Health Therapy, LLC
• Shining Star Dialysis Inc (Newark Dialysis Center)
• James Shipman
• Sara Margaret Shirley

• Anesthesiology Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Anesthesiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.
• 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.