Timothy J Shin, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

11020016A Issued in IN

Practice address

715 Richland Mall
Ontario, OH 44906-3802

Phone

(419) 775-1091

NPI assigned

Jun 20, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Otolaryngology

Education

Ohio State University College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Central Ohio Family Care Center IncGroup PAC ID 3274437082, 194 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avita Ontario Hospital, Ontario, OH, CCN 360365
• Galion Community Hospital Hospital, Galion, OH, CCN 361325
• Bucyrus Community Hospital Hospital, Bucyrus, OH, CCN 361316

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: tshin251227@direct.osumc.edu

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.

• North Central Ohio Family Care Center, Inc

  • Specialist
  • Galion, OH
  • NPI 1689822827
  Medicare reassignment Care Compare group

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

• Avita Ontario Hospital

  • General Acute Care Hospital
  • Ontario, OH
  • NPI 1790131050
  Care Compare affiliation
• Bucyrus Community Hospital LLC

  dba Bucyrus Community Hospital

  • Critical Access Hospital
  • Bucyrus, OH
  • NPI 1104914274
  Care Compare affiliation
• Galion Community Hospital

  dba GCH Health Services

  • Critical Access Hospital
  • Galion, OH
  • NPI 1215907522
  Care Compare affiliation

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1386138535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N COLUMBUS ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271455",
            "telephone_number": "419-462-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 RICHLAND MALL",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449063802",
            "telephone_number": "419-775-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "11020016A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Schlegel, RPH
• Kharawn Scurry
• Kelsey Seidlitz
• Amanda Seiter, MOT, OTR/L
• Shelia a. Fuller, O.D., L.L.C (Shelia Fuller OD)
• Megan Shipper, PHARMD
• Shoptikal LLC (Shopko Optical 4320)
• Tontoh Monroe Simpson, DC
• Amanda Smith
• Brittany Smith, CPT

• Otolaryngology Physician in Ontario, OH
• Providers in Ontario, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.