Kyung H Shin, MD

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

619 River Dr
Elmwood Park, NJ 07407-1317

Phone

(800) 738-1659

Fax

(704) 871-2128

NPI assigned

Jul 17, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• The Mackool Eye Institute, LLC

  • Ambulatory Surgical Clinic/Center
  • Astoria, NY
  • NPI 1851343719
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386662492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088500280",
            "telephone_number": "800-738-1659",
            "fax_number": "704-871-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 RIVER DR",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071317",
            "telephone_number": "800-738-1659",
            "fax_number": "704-871-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "KYUNG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandra Sanchez, DMD
• Kristappa Sangavaram, M.D.
• Sawp LLC
• Kenneth Steven Schwartz, D.D.S.
• Pritee Shah, PT
• Shining Minds LLC
• Eyal Simchi, DMD
• Simply Endodontics LLC
• Michael Singer, D.D.S.
• Jessica Singh, DPM

• Specialist in Elmwood Park, NJ
• Providers in Elmwood Park, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.