Peter E Shin, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

A106933 Issued in CA

Practice address

1509 Wilson Ter
Emergency Dept. - Glendale Adventist Medical Center
Glendale, CA 91206-4007

Phone

(818) 409-8000

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glendale Adventist Emergency Physicians IncorporatedGroup PAC ID 1254563869, 26 clinicians

Synergy Observation Specialists PCGroup PAC ID 5496138307, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239
• Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

Merit-based Incentive Payment System (MIPS)

Final score

94.08 of 100Reported as group

Quality

72.14

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Glendale Adventist Emergency Physicians Incorporated

  • Emergency Medicine Physician
  • Glendale, CA
  • NPI 1679907869
  Medicare reassignment Care Compare group
• Synergy Observation Specialists PC

  • Emergency Medicine Physician
  • Simi Valley, CA
  • NPI 1023773587
  Medicare reassignment Care Compare group
• Hollywood Presbyterian Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1972826931
  NPD (past)
• Parker Valley Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Glendale, CA
  • NPI 1467755249
  NPD (past)
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277
  NPD (past)

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

• Glendale Adventist Medical Center

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1831188275
  Care Compare affiliation
• Simi Valley Hospital and Health Care Services

  • General Acute Care Hospital
  • Simi Valley, CA
  • NPI 1063495190
  Care Compare affiliation

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1083754261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E BROADWAY",
            "address_2": "#311",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051047",
            "telephone_number": "818-396-4383",
            "fax_number": "818-396-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "address_2": "EMERGENCY DEPT. - GLENDALE ADVENTIST MEDICAL CENTER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "PETER",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A106933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Shim, BCBA
• Shin Acupuncture and Herbs, Inc.
• Shin Acupuncture and Herbs, Inc.
• Dong Kil Shin, L.AC.
• Jenny Jeongwon Shin, PHARMD
• Manohar Sambhaji Shinde, MD PHD
• Shine Hospice and Palliative Care
• Shine MMG Inc
• Kathy Shinozaki, P.A.
• Mariah Shipp

• Emergency Medical Services (Emergency Medicine) Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Emergency Medical Services (Emergency Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.