Individual provider Active NPI

Nicole Jimin Shin, MD

  • Pain Medicine (Anesthesiology) Physician
  • Saint Louis, MO
National Provider Identifier
1447645320
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
2020020208 Issued in MO
Practice address
3015 N Ballas Rd
Div Anes Pain MGT
Saint Louis, MO 63131-2329
Phone
(314) 996-7200
Fax
(314) 996-7376
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2020020208 MO
Pain Medicine (Anesthesiology) Physician 207LP2900X 2020020208 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Div Anes Pain MGT
Saint Louis, MO 63131-2329

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 996-7200

Other identifiers 1

IdentifierTypeStateIssuer
200089567MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20200902000962 MO Practitioner - AnesthesiologyPractitioner - Pain Management 7719217652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Washington University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

3015 N Ballas Rd
Dept of Anesthesiology
St Louis, MO 63131-2329
Phone (314) 996-5000

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162
  • Memorial Hospital Hospital, Belleville, IL, CCN 140185
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020020208MOMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Aug 1, 2020 Accepting new patients
Washington University CurrentSince Aug 1, 2020 Accepting new patients
Washington University PastSince Nov 16, 2021 Accepting new patients

Locations

660 S Euclid Ave
#8054
Saint Louis, MO 63110
Phone (314) 286-1045

660 S Euclid Ave
Saint Louis, MO 63110

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

4921 Parkview Pl
Ste 14C
Saint Louis, MO 63110
Phone (314) 290-7500

1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966

Interoperability endpoints

  • Direct secure messaging: nshin1291021@direct.carenet.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 5

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1447645320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-996-7200",
            "fax_number": "314-996-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "address_2": "DIV ANES PAIN MGT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-7200",
            "fax_number": "314-996-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "NICOLE",
        "middle_name": "JIMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2025-04-17",
        "certification_date": "2020-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2020020208",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2020020208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200089567",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "3015 N Ballas Rd",
            "address_2": "Div Anes Pain Mgt",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.