Kathy Shin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00643700 Issued in NJ

Practice address

246 South Ave
Suite 106
Fanwood, NJ 07023-1220

Phone

(908) 366-7605

NPI assigned

Jul 6, 2011

Last updated

Jun 2, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Fanwood Eye Care LLC

  • Optometrist
  • Fanwood, NJ
  • NPI 1396281564
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496361600000",
    "number": "1457648867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 SOUTH AVE",
            "address_2": "#106",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "07023",
            "telephone_number": "908-379-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 SOUTH AVE",
            "address_2": "SUITE 106",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231220",
            "telephone_number": "908-366-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "KATHY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2017-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00643700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Sarnoski, LCSW
• Joseph A Scalia, DO
• Lauren Schnell, M.ED., BCBA
• Scotch Plains Fanwood Dental Care Corp
• Raymond Shek, DPT
• Jennifer Souza
• Speech and Feeding Associates
• Spine and Joint Pain Center LLC
• Angelica Spirito, BCBA
• Suburban Medical Group, P,a.

• Optometrist in Fanwood, NJ
• Providers in Fanwood, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2017; 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.