Mimie Pak Shin, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT25275 Issued in CA

Practice address

21 Upper Ragsdale Dr
Suite #125
Monterey, CA 93940-7831

Phone

(831) 372-2963

Fax

(831) 656-9179

NPI assigned

Dec 18, 2006

Last updated

Jul 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myers Physical Therapy IncGroup PAC ID 2062590284, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Myers Physical Therapy, Inc.

  • Orthopedic Physical Therapist
  • Salinas, CA
  • NPI 1558550673
  Medicare reassignment Care Compare group NPD
• Theresa M Taylor

  dba Central Coast Physical Therapy

  • Physical Therapist
  • Salinas, CA
  • NPI 1528040029
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1083777627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25580 VIA CAZADOR",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939238406",
            "telephone_number": "831-682-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 UPPER RAGSDALE DR",
            "address_2": "SUITE #125",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407831",
            "telephone_number": "831-372-2963",
            "fax_number": "831-656-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "MIMIE",
        "middle_name": "PAK",
        "credential": "M.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT25275",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN NUMBER",
            "identifier": "0PT25270",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC RAILROAD PIN",
            "identifier": "P00362453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elia Sherman
• Anna Jing Shi, M.D.
• Blynn L Shideler, M.D., P.C.
• Roger Shiffman, M.D.
• David D Shin, DDS
• Seokmoon Shin
• Catherine Shirley
• Gregory T Sholeff, MD
• Shoreline Oncology and Hematology Inc
• Maurice Shortall, MFTI

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.