Active NPI
Andrew Shin, PA
- Physician Assistant
- Boston, MA
National Provider Identifier
1588447080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 18 Newbury St FL 5
Boston, MA 02116-3246 - Phone
- (617) 304-1965
- NPI assigned
- Aug 17, 2023
- Last updated
- May 16, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
18 Newbury St FL 5
Boston, MA 02116-3246
Mailing address
67 Lubec St Apt 4
East Boston, MA 02128-4957
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240904002373 | NY | Order and Referring Only - Physician Assistant | 8325588452 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- ashin4362859@nychhc.direct-ci.com
Organizations & group practices 1
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.
-
dba Jacobi Medical Center
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1588447080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 LUBEC ST APT 4",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021284957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 NEWBURY ST FL 5",
"city": "BOSTON",
"state": "MA",
"postal_code": "021163246",
"telephone_number": "617-304-1965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "ANDREW",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-17",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.