James S Shin OD a Professional

Primary specialty

OptometristTaxonomy code 152W00000X

License

11745T Issued in CA

Legal business name

JAMES S SHIN OD A PROFESSIONAL

Practice address

1556 Meridian Ave
San Jose, CA 95125-5319

Phone

(408) 445-2020

Fax

(408) 445-2712

NPI assigned

Dec 16, 2010

Organization subpart

No

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

Authorized official

Name

James S Shin, ODNPI 1518015056

Title

Owner

Phone

(408) 445-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Shin, O.D.

  • Optometrist
  • San Jose, CA
  • NPI 1518015056
  Medicare reassignment Authorized official
• Theresa M. Cervinski, O.D.

  • Optometrist
  • Riverside, CA
  • NPI 1336218445
  NPD (past)
• Bradford G Murray, O.D.

  • Vision Therapy Optometrist
  • San Jose, CA
  • NPI 1043207889
  NPD (past)

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1568765352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1556 MERIDIAN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255319",
            "telephone_number": "408-445-2020",
            "fax_number": "408-445-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1556 MERIDIAN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255319",
            "telephone_number": "408-445-2020",
            "fax_number": "408-445-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES S SHIN OD A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-445-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11745T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SD0117451",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U86248",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamah Dental Corporation
• Hani Sulaiman Jamah, DDS
• Yerania Jamaica Cabrera
• James L Andrews MD Inc
• James Petros, M.D., Inc.
• James Scott Plank
• Elsa James
• Jenci James
• Katheryne Tobin James, HHP, CMT, MQT
• Sonia James, RN

• Optometrist in San Jose, CA
• Providers in San Jose, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.