John Junghoon Shin, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

25MA07717400 Issued in NJ

Practice address

385 Tremont Ave
Veterans Affairs Medical Center, Medical (111)
East Orange, NJ 07018-1023

Phone

(973) 676-1000

Fax

(973) 395-7091

NPI assigned

Jul 27, 2006

Sex

Male

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Lakewood Resource and Referral Center Inc

  • Federally Qualified Health Center (FQHC)
  • Lakewood, NJ
  • NPI 1083748297

  NJ

  Medicare reassignment NPD
• Lakewood Resource and Referral Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, NJ
  • NPI 1124844816
  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477577682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ABBEY CT",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501801",
            "telephone_number": "201-676-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "address_2": "VETERANS AFFAIRS MEDICAL CENTER, MEDICAL (111)",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023",
            "telephone_number": "973-676-1000",
            "fax_number": "973-395-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JOHN",
        "middle_name": "JUNGHOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA07717400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalene Roberts Shepherd, APN, C-ANP
• Erin Renee Sherman, O.D.
• Kalpana Sheth, PA-C
• Shibo Trans Corp
• Lynn Shih, RN
• Augini Ramses Sidhom, DPM
• Sierra House
• Michelle Silber, OTR/L
• Eryn Aimee Sileo
• Bilal Simms, LCADC, CCS, MAC

• All providers in East Orange, NJ
• Endocrinology, Diabetes & Metabolism Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.