Individual provider Active NPI

Marie H Jhin, M.D.

  • Specialist
  • San Carlos, CA
National Provider Identifier
1104878321
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A70851 Issued in CA
Practice address
378 El Camino Real
San Carlos, CA 94070-2408
Phone
(650) 551-9700
Fax
(650) 551-9702
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A70851 CA Primary

Addresses

Primary practice location

378 El Camino Real
San Carlos, CA 94070-2408

Mailing address

378 El Camino Real
San Carlos, CA 94070-2408
Phone (650) 551-9700

Other identifiers 3

IdentifierTypeStateIssuer
7928260OtherCAAETNA
2064370OtherCAFIRST HEALTH
5274486OtherCACCN

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
I20051121001065 CA Practitioner - Dermatology 0244259067 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A70851CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Medical Group of San Francisco, Inc Specialist CurrentSince Jul 2, 2015 Accepting new patients
Dermatology Medical Group of SF Specialist PastSince Jul 2, 2015 Accepting new patients

Locations

490 Post St
Ste 700
San Francisco, CA 94102
Phone (415) 362-2238

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1104878321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 EL CAMINO REAL",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702408",
            "telephone_number": "650-551-9700",
            "fax_number": "650-551-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 EL CAMINO REAL",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702408",
            "telephone_number": "650-551-9700",
            "fax_number": "650-551-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JHIN",
        "first_name": "MARIE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A70851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7928260",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2064370",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "5274486",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.