Individual provider Active NPI

Pomi Shin

  • Adult Health Nurse Practitioner
  • Glen Burnie, MD
National Provider Identifier
1235781691
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R187271 Issued in MD
Practice address
7927 Ritchie Hwy
Glen Burnie, MD 21061-4345
Phone
(410) 761-2273
NPI assigned
Jul 15, 2019
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R187271 MD Primary

Addresses

Primary practice location

7927 Ritchie Hwy
Glen Burnie, MD 21061-4345

Mailing address

7927 Ritchie Hwy
Glen Burnie, MD 21061-4345
Phone (410) 761-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200121000200 MD Practitioner - Nurse Practitioner 6709211733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Family Care IncGroup PAC ID 5092629394, 157 clinicians

Practice addresses (Care Compare)

7927 Ritchie Hwy
Glen Burnie, MD 21061-4343
Phone (410) 761-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R187271MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists Inc CurrentSince Dec 12, 2019 Accepting new patients
St Paul Place Specialists, Inc. CurrentSince Dec 12, 2019 Accepting new patients
Maryland Family Care, Inc. CurrentSince Jun 1, 2021 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

7927 Ritchie Hwy
Glen Burnie, MD 21061
Phone (410) 494-9099

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Interoperability endpoints

  • Direct secure messaging: pshin48220@direct.mdmercy.com

Organizations & group practices 5

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 2

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1235781691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7927 RITCHIE HWY",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614345",
            "telephone_number": "410-761-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7927 RITCHIE HWY",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614345",
            "telephone_number": "410-761-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "POMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R187271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.