NPIMap

Individual provider Active NPI

Esther Haerim Shin, M.D.

  • Pediatrics Physician
  • New Haven, CT
National Provider Identifier
1376955534
Registry record updated Jun 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10781873-1205 Issued in UT
Practice address
20 York St
New Haven, CT 06510
Phone
(203) 688-4242
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10781873-1205 UT
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 10781873-1205 UT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510

Mailing address

15 York St
LMP 1091B
New Haven, CT 06510-3221
Phone (203) 785-7941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180726000810 TX Practitioner - Pediatric Medicine 1557669934 Reassigns benefits to 1 organization
I20200129001625 UT Practitioner - Pediatric Medicine 1557669934 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Tufts University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
61.32
Improvement activities
40
Cost
90.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10781873-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 8, 2019 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince May 30, 2020 Accepting new patients
University of Utah Pediatric Acuity Care Pediatrics Current Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 8, 2019 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility Current Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Dec 8, 2019 Accepting new patients
University of Utah Adult Services CurrentSince May 30, 2020 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Jul 2, 2018 Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Dec 8, 2019 Accepting new patients

Locations

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 11

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530316800000",
    "number": "1376955534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 YORK ST",
            "address_2": "LMP 1091B",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103221",
            "telephone_number": "203-785-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "ESTHER",
        "middle_name": "HAERIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2018-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "10781873-1205",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "10781873-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.