Hae Won Shin, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD067779L Issued in PA

Practice address

10800 Knights Rd
Attn: Radiology
Philadelphia, PA 19114-4200

Phone

(215) 612-2610

Fax

(215) 612-5077

NPI assigned

Jan 25, 2006

Last updated

Jan 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Jefferson Medical College of Thomas Jefferson University, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians

Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Jefferson University Radiology Associates LLC

  dba Jefferson Outpatient Imaging

  • Radiology Clinic/Center
  • Philadelphia, PA
  • NPI 1578512224

  Diagnostic Radiology

  Medicare reassignment NPD
• Jefferson University Physicians of New Jersey, P.C.

  • Internal Medicine Physician
  • Voorhees, NJ
  • NPI 1083039200
  Medicare reassignment NPD
• Jefferson University Radiology Associates, LLC

  dba Jefferson Outpatient Imaging

  • Radiology Clinic/Center
  • Marlton, NJ
  • NPI 1972169902

  Diagnostic Radiology

  Medicare reassignment NPD
• Jefferson University Radiology Associates, LLC

  dba Jefferson Outpatient Imaging

  • Radiology Clinic/Center
  • Philadelphia, PA
  • NPI 1063067635

  Diagnostic Radiology

  NPD
• Jefferson University Radiology Associates, LLC

  dba Jefferson Outpatient Imaging

  • Radiology Clinic/Center
  • Sewell, NJ
  • NPI 1225678352

  Diagnostic Radiology

  NPD
• Radiology Associates of New Jersey PC

  • Diagnostic Radiology Physician
  • Cherry Hill, NJ
  • NPI 1659390870

  Body Imaging

  NPD (past)

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

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1407826183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 782743",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191782743",
            "telephone_number": "602-910-6887",
            "fax_number": "215-612-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "address_2": "ATTN: RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-2610",
            "fax_number": "215-612-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "HAE WON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD067779L",
            "primary": true
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "PA",
            "license": "MD067779L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA08184800",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NJ",
            "license": "25MA08184800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Shimp
• Amy Shin, PHARMD
• David Shin
• Eon K Shin, MD
• Eunice Shin, M.D.
• Jane Shin
• Ji Young Shin, MD
• John Hong Shin, MD
• Justin Jonghyun Shin, MD
• Kyonghui Janice Shin, LCSW

• Diagnostic Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.