Individual provider Active NPI

Jane Shin

  • Diagnostic Radiology Physician
  • Shenandoah, TX
National Provider Identifier
1417311887
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
T5207 Issued in TX
Practice address
17183 I 45 S Ste 310
Shenandoah, TX 77385-3313
Phone
(936) 270-3600
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X T5207 TX Primary

Addresses

Primary practice location

17183 I 45 S Ste 310
Shenandoah, TX 77385-3313

Mailing address

17183 I 45 S Ste 310
Shenandoah, TX 77385-3313

Other practice location 1

6431 Fannin St, Suite MSB 2.116
Houston, TX 77030-5398
Phone (713) 500-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220629003791 TX Practitioner - Diagnostic Radiology 7012397508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Radiology Associates, PLLCGroup PAC ID 3678652625, 15 clinicians

Practice addresses (Care Compare)

The Woodlands, TX 77385
Phone (936) 270-3631

16655 Southwest Fwy
Sugar Land, TX 77479-2329
Phone (713) 441-7465

18220 State Hwy 249
Suite 1280
Houston, TX 77070-4347
Phone (281) 737-1900

18220 Tomball Pkwy
Houston, TX 77070-4347
Phone (713) 441-7465

2615 Southwest Fwy
Suite 110
Houston, TX 77098-4609
Phone (713) 441-9740

6550 Fannin St
Suite 749
Houston, TX 77030-2738
Phone (713) 441-7465

6565 Fannin St
Houston, TX 77030-2703
Phone (713) 441-7465

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T5207TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Radiology Associates, PLLC Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Methodist Health Centers PastSince Aug 14, 2022 Accepting new patients
TMH Physician Associates PLLC Past Accepting new patients

Locations

6550 Fannin St
Ste 749
Houston, TX 77030
Phone (713) 441-5097

6565 Fannin St
#623
Houston, TX 77030
Phone (713) 363-8584

17183 Interstate 45 S
Ste 310
Shenandoah, TX 77385
Phone (877) 493-3228

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

17201 Interstate 45 S
Ste 310
The Woodlands, TX 77385
Phone (936) 270-3631

Interoperability endpoints

  • Direct secure messaging: jshin406735@directhoustonmethodist.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1417311887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17183 I 45 S STE 310",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773853313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17183 I 45 S STE 310",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773853313",
            "telephone_number": "936-270-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin St, Suite MSB 2.116",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770305398",
            "country_code": "US",
            "telephone_number": "713-500-7640",
            "fax_number": "713-500-7647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "T5207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.