Individual provider Active NPI

In C Shin, MD

  • Ophthalmology Physician
  • Montgomery, AL
National Provider Identifier
1245215656
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
26114 Issued in AL
Practice address
2752 Zelda Rd
Montgomery, AL 36106-2694
Phone
(334) 481-2800
Fax
(334) 270-3375
NPI assigned
Dec 8, 2005
Last updated
Dec 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 26114 AL Primary

Addresses

Primary practice location

2752 Zelda Rd
Montgomery, AL 36106-2694

Mailing address

2752 Zelda Rd
Montgomery, AL 36106-2694
Phone (334) 481-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20040819001035 AL Practitioner - Ophthalmology 7012820517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Alabama School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montgomery Eye Physicians PCGroup PAC ID 7113990805, 6 clinicians

Practice addresses (Care Compare)

2752 Zelda Rd
Montgomery, AL 36106-2694
Phone (334) 271-3804

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.11 of 100Reported as group
Quality
92.57
Improvement activities
40
Cost
86.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery392

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26114ALMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Eye Physicians P.C Ophthalmology CurrentSince Sep 7, 2004 Accepting new patients
Montgomery Eye Physicians P.C Ophthalmology CurrentSince Sep 7, 2004 Accepting new patients

Locations

2752 Zelda Rd
Montgomery, AL 36106
Phone (334) 270-9677

8131 Seaton Pl
Montgomery, AL 36116
Phone (334) 323-1889

1976 Fairview Ave
Prattville, AL 36066
Phone (334) 271-3804

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 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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1245215656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2752 ZELDA RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062694",
            "telephone_number": "334-481-2800",
            "fax_number": "334-270-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2752 ZELDA RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062694",
            "telephone_number": "334-481-2800",
            "fax_number": "334-270-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "IN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "26114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.