Active NPI
Lisa Shin, O.D.
- Optometrist
- Los Alamos, NM
National Provider Identifier
1427150994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 476
- Practice address
- 800 Trinity Dr. Ste B
Los Alamos, NM 87544-4102 - Phone
- (505) 662-9681
- NPI assigned
- Sep 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 476 | NM | Primary |
Addresses
Primary practice location
800 Trinity Dr. Ste B
Los Alamos, NM 87544-4102
Mailing address
800 Trinity Dr. Ste B
Los Alamos, NM 87544-4102
Phone (505) 662-9681
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225756800000",
"number": "1427150994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 TRINITY DR. STE B",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875444102",
"telephone_number": "505-662-9681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 TRINITY DR. STE B",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875444102",
"telephone_number": "505-662-9681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-03",
"last_updated": "2008-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NM",
"license": "476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.