Active NPI
Samuel Shin, MD, PHD
- Psychiatry Physician
- North Olmsted, OH
National Provider Identifier
1609510866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 35.150427
- Practice address
- 24700 Lorain Rd
North Olmsted, OH 44070-2088 - Phone
- (216) 444-2200
- NPI assigned
- Apr 25, 2022
- Last updated
- May 13, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35.150427 | OH | Primary |
Addresses
Primary practice location
24700 Lorain Rd
North Olmsted, OH 44070-2088
Mailing address
24700 Lorain Rd
North Olmsted, OH 44070-2088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.150427 | OH | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1609510866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24700 LORAIN RD",
"city": "NORTH OLMSTED",
"state": "OH",
"postal_code": "440702088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24700 LORAIN RD",
"city": "NORTH OLMSTED",
"state": "OH",
"postal_code": "440702088",
"telephone_number": "216-444-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "SAMUEL",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-25",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "35.150427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Olmsted, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.