Individual provider Active NPI

Sang Ha Shin, MD

  • Internal Medicine Physician
  • Senoia, GA
National Provider Identifier
1265069769
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
95937 Issued in GA
Practice address
7990 Wells St Ste 100
Senoia, GA 30276-2267
Phone
(470) 947-6010
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 95937 GA Primary

Addresses

Primary practice location

7990 Wells St Ste 100
Senoia, GA 30276-2267

Mailing address

7990 Wells St Ste 100
Senoia, GA 30276-2267
Phone (470) 947-6010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240326001667 GA Practitioner - Internal Medicine 8224450176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

7990 Wells St
Suite 100
Senoia, GA 30276-2267
Phone (470) 947-6010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Internal Medicine CurrentSince Jun 17, 2024 Accepting new patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Feb 16, 2024 Accepting new patients
Piedmont Providers LLC Internal Medicine PastSince Jun 17, 2024 Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

7990 Wells St
Ste 100
Senoia, GA 30276
Phone (470) 947-6010

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1265069769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7990 WELLS ST STE 100",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302762267",
            "telephone_number": "470-947-6010",
            "fax_number": "404-738-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7990 WELLS ST STE 100",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302762267",
            "telephone_number": "470-947-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SANG HA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "95937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Senoia, GA

Sources for this page

Verify at the official NPI Registry.