Individual provider Active NPI

Young J Shin, M.D.

  • Psychiatry Physician
  • Poughkeepsie, NY
National Provider Identifier
1447220884
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
133560 Issued in NY
Practice address
230 North Rd
Poughkeepsie, NY 12601
Phone
(802) 461-6851
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 133560 NY Primary

Addresses

Primary practice location

230 North Rd
Poughkeepsie, NY 12601

Mailing address

29 N Hamilton St
Poughkeepsie, NY 12601-2541

Other practice location 1

389 Hooker Ave
Poughkeepsie, NY 12603-3633
Phone (845) 471-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060429000000 NY Practitioner - Psychiatry 5698785079 Reassigns benefits to 2 organizations
Practice locations: Poughkeepsie, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Services, Inc.Group PAC ID 1658284542, 39 clinicians

Practice addresses (Care Compare)

230 N Rd
Poughkeepsie, NY 12601-1328
Phone (845) 486-2703

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access: Supports for Living Inc. CurrentSince Nov 10, 2014 Accepting new patients
Family Services, Inc. Psychiatry CurrentSince Apr 22, 2019 Accepting new patients
Access: Supports for Living Inc CurrentSince Nov 10, 2014 Accepting new patients
Neil I. Teicher, L.C.S.W. Past Accepting new patients

Locations

223 Main St
Beacon, NY 12508
Phone (845) 838-4900

67 Windsor Hwy
Newburgh, NY 12553
Phone (845) 562-6850

29 N Hamilton St
Poughkeepsie, NY 12601
Phone (845) 452-1110

230 North Rd
Poughkeepsie, NY 12601
Phone (845) 452-0774

15 Fortune Rd W
Scotchtown, NY 10941
Phone (845) 673-7123

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1447220884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 N HAMILTON ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126012541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "802-461-6851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "389 Hooker Ave",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126033633",
            "country_code": "US",
            "telephone_number": "845-471-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "YOUNG",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "133560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.