Shelbi Ching Jim on, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD-20868 Issued in HI

Practice address

3221 Waialae Ave Ste 382
Honolulu, HI 96816-5845

Phone

(808) 940-0961

Fax

(808) 201-4951

NPI assigned

Mar 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in HI

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

Dermatology

Education

University of Hawaii John a. Burns School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (4 of 6)

Locations

Networks

• devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335
• HI PPO

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00326

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.

• Malama Dermatology, LLC

  • Dermatology Physician
  • Honolulu, HI
  • NPI 1194568212
  Medicare reassignment NPD Authorized official
• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment NPD
• Stella S. Matsuda, M.D., Inc.

  • Specialist
  • Honolulu, HI
  • NPI 1649239856
  Medicare reassignment NPD
• Health Quest Physical Therapy, P.C.

  • Specialist
  • Forest Hills, NY
  • NPI 1851571160
  NPD

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1184923765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 WAIALAE AVE STE 382",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165845",
            "telephone_number": "808-940-0961",
            "fax_number": "808-201-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 WAIALAE AVE STE 382",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165845",
            "telephone_number": "808-940-0961",
            "fax_number": "808-201-4951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 E 98th St # 1048",
            "address_2": "Mt Sinai School of Medicine, Dept of Dermatology",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296501",
            "country_code": "US",
            "telephone_number": "212-241-3288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1276 Fulton Ave Ste 228",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10456",
            "country_code": "US",
            "telephone_number": "718-992-7669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 N Kuakini St Ste 703",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968176302",
            "country_code": "US",
            "telephone_number": "808-949-7568",
            "fax_number": "808-941-3112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIM ON",
        "first_name": "SHELBI",
        "middle_name": "CHING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "265484",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "HI",
            "license": "MD-20868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD-20868",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04683730",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jet Dental of Hawaii LLC
• Jewish Community Services of Hawaii
• Alan Jichaku, LMT
• Jill C. Peterson LLC
• Megan Hiroko Jim on
• Oswald Willim Jim
• Teodora Jim, LPN
• Yamileth Jimenez Valencia, LMT
• Ann Jimenez
• Eric Jimenez

• Dermatology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Dermatology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; 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.