Jennifer Shin Yim, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA22803 Issued in CA

Practice address

1650 S Euclid Ave
Ontario, CA 91762-5824

Phone

(909) 391-4138

NPI assigned

Apr 4, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Universal Multispecialty Medical Group IncGroup PAC ID 5890038616, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Universal Multi Specialty Medical Group Inc

  • Internal Medicine Physician
  • Ontario, CA
  • NPI 1124543129
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1588907802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917625824",
            "telephone_number": "909-391-4138",
            "fax_number": "909-391-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917625824",
            "telephone_number": "909-391-4138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8239 Rochester Ave",
            "address_2": "Suite #120",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917300714",
            "country_code": "US",
            "telephone_number": "909-941-0266",
            "fax_number": "909-941-0569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIM",
        "first_name": "JENNIFER",
        "middle_name": "SHIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "22803",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemary Yates, LVN
• Angela Maria Ybanez
• Yen Shiu Shih DDS Prof. Inc.
• Claudia Yepez
• Krupakar Yeturu, D.D.S
• Joshua Hangul Yim, OD
• Alexandra Yniguez
• Ashley Marie Yoder, LCSW
• Claudia Yoder
• Yong J. Shin, D.D.S. Inc

• Medical Physician Assistant in Ontario, CA
• Providers in Ontario, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.

Verify at the official NPI Registry.