Individual provider Active NPI

Lynn Hae Shin, M.D.

  • Vascular Surgery Physician
  • Montebello, CA
National Provider Identifier
1346341591
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
G86318 Issued in CA
Practice address
600 W Beverly Blvd Ste C
Montebello, CA 90640-3660
Phone
(323) 869-0870
Fax
(323) 869-0875
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X G86318 CA Primary

Addresses

Primary practice location

600 W Beverly Blvd Ste C
Montebello, CA 90640-3660

Mailing address

600 W Beverly Blvd Ste C
Montebello, CA 90640-3660
Phone (323) 869-0870

Other identifiers 1

IdentifierTypeStateIssuer
00G863180MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20201113000582 NM Practitioner - Vascular Surgery 9638134034 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Maryland School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1012 Marquez PL
Unit 106B
Santa Fe, NM 87505-1833
Phone (310) 445-5999

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue111
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G86318CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vessel Health LLC CurrentSince Feb 14, 2022 Accepting new patients
Skilled Biologics, Inc. CurrentSince Aug 19, 2024 Accepting new patients
Skilled Facility Health Care Solutions Inc CurrentSince Oct 26, 2020 Accepting new patients
Christos D. Dossa MD PC Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Locations

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

3747 Foothill Blvd
#B140
La Crescenta, CA 91214
Phone 3104455999255

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

500 Louisiana Blvd NE
Albuquerque, NM 87108
Phone (505) 255-1717

10601 4th St NW
Albuquerque, NM 87114
Phone (505) 828-3000

110 E Broadway St
Hobbs, NM 88240
Phone (844) 800-2735

1012 Marquez Pl
Unit 106B
Santa Fe, NM 87505
Phone (505) 470-8132

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346341591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W BEVERLY BLVD STE C",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403660",
            "telephone_number": "323-869-0870",
            "fax_number": "323-869-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W BEVERLY BLVD STE C",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403660",
            "telephone_number": "323-869-0870",
            "fax_number": "323-869-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "LYNN",
        "middle_name": "HAE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G86318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G863180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.