Active NPI
Peter C. Shin, M.D.
- Neurological Surgery Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- MD2013-0879
- Practice address
- MSC 10 5615
1 University of New Mexico
Albuquerque, NM 87131-0001 - Phone
- (505) 272-3401
- Fax
- (505) 272-6091
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | MD00040264 | WA | |
| Neurological Surgery Physician | 207T00000X | MD2013-0879 | NM | Primary |
Addresses
Primary practice location
MSC 10 5615
1 University of New Mexico
Albuquerque, NM 87131-0001
Mailing address
800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310
Phone (505) 272-1476
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0150866 | Other | WA | L&I NUMBER |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | SRMC@direct.health.unm.edu | ||
| Direct Messaging Address | UNMH@direct.health.unm.edu | ||
| Direct Messaging Address | UNMMG@direct.health.unm.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Northeastern Ohio University College of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.64 of 100
- Quality
- 75.49
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.92
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 37 |
| Laminectomy or laminotomy (partial removal of spine bones) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00040264 | WA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unm Medical Group Inc | Current | Accepting new patients | |
| Unm Medical Group, Inc. | Current | Accepting new patients | |
| Bayhealth Medical Center, Inc | Neurological Surgery | Past | Accepting new patients |
| Unm Hospital | Past | Accepting new patients | |
| South Sound Neurosurgery PLLC | Neurological Surgery | Past | Accepting new patients |
Locations
933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476
800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476
3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
Interoperability endpoints
- https://api.platform.athenahealth.com/9932/brand/1/csg/1/fhir/r4
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Albuquerque, NM
- NPI 1831218627
-
dba UNM Truman Health Services Pharmacy
- Community/Retail Pharmacy
- Albuquerque, NM
- NPI 1417330044
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1689747552
-
dba Bayhealth Physicians
- Colon & Rectal Surgery Physician
- Dover, DE
- NPI 1285809509
Neurological Surgery
-
- Durable Medical Equipment & Medical Supplies
- Puyallup, WA
- NPI 1013503523
Neurological Surgery
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CHRISTUS St. Vincent Regional Medical Center
- General Acute Care Hospital
- Santa Fe, NM
- NPI 1578587150
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1689747552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1568522035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 BRADBURY DR SE STE 116",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064310",
"telephone_number": "505-272-1476",
"fax_number": "505-272-6901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MSC 10 5615",
"address_2": "1 UNIVERSITY OF NEW MEXICO",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-3401",
"fax_number": "505-272-6091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "PETER",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "WA",
"license": "MD00040264",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "NM",
"license": "MD2013-0879",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I NUMBER",
"identifier": "0150866",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "SRMC@direct.health.unm.edu",
"affiliation": "N",
"address_1": "3001 Broadmoor Blvd NE",
"city": "Rio Rancho",
"state": "NM",
"country_code": "US",
"postal_code": "871442100",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "UNMH@direct.health.unm.edu",
"affiliation": "N",
"address_1": "2211 Lomas Blvd NE",
"city": "Albuquerque",
"state": "NM",
"country_code": "US",
"postal_code": "871062719",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "UNMMG@direct.health.unm.edu",
"affiliation": "N",
"address_1": "800 Bradbury Dr SE Ste 116",
"city": "Albuquerque",
"state": "NM",
"country_code": "US",
"postal_code": "871064310",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.