Individual provider Active NPI

Shin Yu Celia Cheung

  • Pediatrics Physician
  • Orange, CA
National Provider Identifier
1093391799
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
PTL6563 Issued in CA
Practice address
505 S Main St Ste 525
Orange, CA 92868-4553
Phone
(714) 456-5631
Fax
(714) 285-0389
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X PTL6563 CA Primary

Addresses

Primary practice location

505 S Main St Ste 525
Orange, CA 92868-4553

Mailing address

505 S Main St Ste 525
Orange, CA 92868-4553
Phone (714) 456-5631

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220812000175 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3072996743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine PastSince Mar 28, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1093391799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEUNG",
        "first_name": "SHIN YU CELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "PTL6563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.