Individual provider Active NPI

Peter Shin, MD

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1194212662
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
T7040 Issued in TX
Practice address
3300 Oak Lawn Ave Ste 200
Dallas, TX 75219-4265
Phone
(214) 252-3500
NPI assigned
Apr 19, 2018
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X T7040 TX Primary

Addresses

Primary practice location

3300 Oak Lawn Ave Ste 200
Dallas, TX 75219-4265

Mailing address

102 Preserve PL
Lewisville, TX 75067-4252
Phone (918) 853-2422

Other practice location 1

920 Stanton L Young Blvd Ste 1140
Oklahoma City, OK 73104-5036
Phone (405) 271-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220722001230 TX Practitioner - Anesthesiology 2567843477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Consultants, LLPGroup PAC ID 3971516642, 137 clinicians

Practice addresses (Care Compare)

3300 Oak Lawn Ave
Suite 200
Dallas, TX 75219-4265
Phone (214) 252-3501

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T7040TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Metropolitan Anesthesia Consultants, LLP Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients

Locations

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

3625 N Hall St
Ste 800
Dallas, TX 75219
Phone (214) 252-3500

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

403 Treeline Park
San Antonio, TX 78209
Phone (210) 294-8000

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1194212662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PRESERVE PL",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674252",
            "telephone_number": "918-853-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAK LAWN AVE STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194265",
            "telephone_number": "214-252-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Stanton L Young Blvd Ste 1140",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045036",
            "country_code": "US",
            "telephone_number": "405-271-4351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "T7040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.