Jae Rock Shim, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95001105 Issued in CA

Practice address

1300 N Vermont Ave
Los Angeles, CA 90027-6098

Phone

(213) 413-3000

NPI assigned

Jan 25, 2019

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, CA2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HP Anesthesia IncGroup PAC ID 6608009766, 34 clinicians

Turiya AnesthesiaGroup PAC ID 0345785523, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coast Plaza Hospital Hospital, Norwalk, CA, CCN 050771
• Hollywood Presbyterian Medical Center Hospital, Los Angeles, CA, CCN 050063

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• HP Anesthesia Inc

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1992133474

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Turiya Anesthesia

  • Anesthesiology Physician
  • Norwalk, CA
  • NPI 1497595565
  Medicare reassignment Care Compare group NPD
• Olympic Anesthesia Partnership

  • Anesthesiology Physician
  • Beverly Hills, CA
  • NPI 1881707586
  Medicare reassignment NPD
• Precision Anesthesia Group Inc

  • Specialist
  • Beverly Hills, CA
  • NPI 1205253929
  Medicare reassignment NPD
• Resource Anesthesiology Associates of NM Inc

  • Anesthesiology Physician
  • Farmington, NM
  • NPI 1386929644
  Medicare reassignment NPD

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

• Cha Hollywood Medical Center, LP

  dba Hollywood Presbyterian Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922033547
  Care Compare affiliation
• CPH Hospital Management LLC

  dba Coast Plaza Hospital

  • General Acute Care Hospital
  • Norwalk, CA
  • NPI 1194016923
  Care Compare affiliation
• CPH Hospital Management LLC

  dba Coast Plaza Hospital

  • Psychiatric Hospital Unit
  • Norwalk, CA
  • NPI 1952012379
  Care Compare affiliation

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1477017275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25033",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927995033",
            "telephone_number": "714-347-1000",
            "fax_number": "714-347-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276098",
            "telephone_number": "213-413-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIM",
        "first_name": "JAE",
        "middle_name": "ROCK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-25",
        "last_updated": "2022-08-02",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.018963",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001105",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN686691",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nick Melvin Shillingford, M.D
• Shiloh Ag and Associates LLC
• Shiloh Family Pharmacy,Inc. (shiloh family pharmacy)
• Shiloh Gog Ministries
• Albert Lee Shim, MD
• Joomee Shim
• Kelly Alexandra Shimada, D.D.S.
• Marianna Shiman
• Peter Shimizu, DDS
• Stephanie Ann Shimizu, DDS

• Certified Registered Nurse Anesthetist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.