Active NPI
In Sook J Shin, MD
- Neurology Physician
- Buffalo, NY
National Provider Identifier
1124090329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 134927-1
- Practice address
- 7 Community Drive
Aspire of Wny, Inc.
Buffalo, NY 14225-2523 - Phone
- (716) 505-5634
- Fax
- (716) 892-1936
- NPI assigned
- Feb 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 134927-1 | NY | Primary |
Addresses
Primary practice location
7 Community Drive
Aspire of Wny, Inc.
Buffalo, NY 14225-2523
Mailing address
7 Community Drive
Aspire of Wny, Inc.
Buffalo, NY 14225-2523
Phone (716) 505-5634
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00474924 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134927-1 | NY | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Neurology, Inc. | Neurology | Past | 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.
-
- Neurology Physician
- Buffalo, NY
- NPI 1649293820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334016000000",
"number": "1124090329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 COMMUNITY DRIVE",
"address_2": "ASPIRE OF WNY, INC.",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142252523",
"telephone_number": "716-505-5634",
"fax_number": "716-892-1936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 COMMUNITY DRIVE",
"address_2": "ASPIRE OF WNY, INC.",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142252523",
"telephone_number": "716-505-5634",
"fax_number": "716-892-1936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "IN SOOK",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-02",
"last_updated": "2012-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "134927-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00474924",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.