Individual provider Active NPI

Sangyong Shin, P.T.

  • Physical Therapist
  • Aurora, CO
National Provider Identifier
1578641700
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7950 Issued in CO
Practice address
14001 E Iliff Ave Ste 215
Aurora, CO 80014-1426
Phone
(303) 341-2277
Fax
(303) 341-7722
NPI assigned
Nov 2, 2006
Last updated
Jan 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7950 CO Primary
Orthopedic Physical Therapist 2251X0800X 7950 CO

Addresses

Primary practice location

14001 E Iliff Ave Ste 215
Aurora, CO 80014-1426

Mailing address

14001 E Iliff Ave Ste 215
Aurora, CO 80014-1426
Phone (303) 341-2277

Other identifiers 1

IdentifierTypeStateIssuer
67782566MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000916 CO Practitioner - Physical Therapist in Private Practice 3173540408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Health, Inc.Group PAC ID 1658398078, 2 clinicians

Practice addresses (Care Compare)

13901 E Exposition Ave
Suite 200
Aurora, CO 80012-2552
Phone (303) 341-2277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7950COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Health PT&OT Physical Therapist CurrentSince Jun 12, 2022 Accepting new patients
All in One Medical Inc Past Accepting new patients

Locations

14001 E Iliff Ave
Ste 215
Aurora, CO 80014
Phone (303) 341-2277

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1578641700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 E ILIFF AVE STE 215",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141426",
            "telephone_number": "303-341-2277",
            "fax_number": "303-341-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 E ILIFF AVE STE 215",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141426",
            "telephone_number": "303-341-2277",
            "fax_number": "303-341-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SANGYONG",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7950",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "7950",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67782566",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.