Clara Chon Shin, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00035516 Issued in WA

Practice address

112 E Broadway Ave
Montesano, WA 98563-3704

Phone

(360) 249-4111

Fax

(360) 249-5220

NPI assigned

Feb 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Internal Medicine

Education

University of Washington School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Capital Medical Center Physicians LLCGroup PAC ID 3678639879, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harbors Home Health / Hospice Home health agency, Hoquiam, WA, CCN 507020
• Assured Home Health and Hospice Home health agency, Centralia, WA, CCN 507042
• Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031
• Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304
• Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
• Capital Medical Center Hospital, Olympia, WA, CCN 500139
• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cshin584852@direct.multicare.org
• Direct secure messaging: cshin66141@ghc.direct-ci.net

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.

• Capital Medical Center Physicians LLC

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1629214283
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Montesano Internal Medicine, PS

  • Internal Medicine Physician
  • Montesano, WA
  • NPI 1073683314
  Medicare reassignment NPD
• Capital Medical Center Physicians LLC

  • Internal Medicine Physician
  • Montesano, WA
  • NPI 1710744792
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Capital Medical Center Physicians LLC

  • Family Medicine Physician
  • Lacey, WA
  • NPI 1649037623
  NPD (past)

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

• Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
  • NPI 1154378859
  Care Compare affiliation
• Grays Harbor County Public Hospital District No 1

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Care Compare affiliation
• Harbors Home Health & Hospice

  • Home Health Agency
  • Hoquiam, WA
  • NPI 1699777276
  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1841258639
  Care Compare affiliation
• Northwest Healthcare Alliance, Inc.

  • Home Health Agency
  • Centralia, WA
  • NPI 1154397305
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1376516401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E BROADWAY AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633704",
            "telephone_number": "360-249-4111",
            "fax_number": "360-249-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E BROADWAY AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633704",
            "telephone_number": "360-249-4111",
            "fax_number": "360-249-5220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 16th Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981125226",
            "country_code": "US",
            "telephone_number": "206-326-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "CLARA",
        "middle_name": "CHON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00035516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300840",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 16th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles Mark Sagen, RPH.
• Peter Edward Sandona
• Jill Sattler, LMT
• Kathleen Marie Schaeffer, OT
• Robert William Schimpf, MD
• Yong Ki Shin, M.D.
• Elizabeth Short, LMP
• Trevor Patrick Solis, CFY-SLP
• Lynda Brady Stafford, DO
• Jennifer Star Steadman

• Internal Medicine Physician in Montesano, WA
• Providers in Montesano, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.