Individual provider Active NPI

David Shin, MD

  • Urology Physician
  • Hackensack, NJ
National Provider Identifier
1558320994
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
25MA07773400 Issued in NJ
Practice address
360 Essex St
Suite 403
Hackensack, NJ 07601-8550
Phone
(551) 996-8090
Fax
(551) 996-8221
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 25MA07773400 NJ Primary

Addresses

Primary practice location

360 Essex St
Suite 403
Hackensack, NJ 07601-8550

Mailing address

360 Essex St
Suite 403
Hackensack, NJ 07601-8550
Phone (551) 996-8090

Other identifiers 1

IdentifierTypeStateIssuer
7586205MedicaidNJ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040921001064 NJ Practitioner - Urology 9931177508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
JS Weill Medical College, Cornell University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

360 Essex St
Hackensack, NJ 07601-8550
Phone (201) 336-8686

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC Urology CurrentSince Sep 1, 2008 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 1, 2008 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients
Urology Specialty Care PA Past Accepting new patients

Locations

360 Essex St
Ste 403
Hackensack, NJ 07601
Phone (551) 996-8090

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

360 Essex St
Hackensack, NJ 07601
Phone (201) 336-8686

Interoperability endpoints

  • Direct secure messaging: david.shin@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

Hospital & facility affiliations 2

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1558320994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST",
            "address_2": "SUITE 403",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018550",
            "telephone_number": "551-996-8090",
            "fax_number": "551-996-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST",
            "address_2": "SUITE 403",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018550",
            "telephone_number": "551-996-8090",
            "fax_number": "551-996-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA07773400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7586205",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.