Jae Y Shin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME94179 Issued in FL

Practice address

3030 N Rocky Point Dr W
Suite 670
Tampa, FL 33607-5906

Phone

(813) 289-6597

Fax

(813) 289-6592

NPI assigned

Oct 6, 2006

Sex

Male

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Toledo College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunstate Physicians LLCGroup PAC ID 3577813617, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
• HCA Florida Largo Hospital Hospital, Largo, FL, CCN 100248

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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.

• Sunstate Physicians LLC

  • Hospitalist Physician
  • Boca Raton, FL
  • NPI 1750872545

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• Professional Health Care of Pinellas LLC

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1881647253
  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164

  Internal Medicine

  NPD
• Professional Health Care of Pinellas Inc.

  • Chiropractor
  • St Petersburg, FL
  • NPI 1568970903
  NPD
• Cogent Healthcare of Fort Myers, LLC

  • Internal Medicine Physician
  • Ft Myers, FL
  • NPI 1952352163
  NPD (past)
• Inpatient Consultants of Florida, Inc.

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1285037622

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Largo Medical Center, Inc.

  • General Acute Care Hospital
  • Largo, FL
  • NPI 1144274879
  Care Compare affiliation
• Morton Plant Hospital Association Inc

  • General Acute Care Hospital
  • Clearwater, FL
  • NPI 1376529743
  Care Compare affiliation

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1619064326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N ROCKY POINT DR W",
            "address_2": "SUITE 670",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075906",
            "telephone_number": "813-289-6597",
            "fax_number": "813-289-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N ROCKY POINT DR W",
            "address_2": "SUITE 670",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075906",
            "telephone_number": "813-289-6597",
            "fax_number": "813-289-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JAE",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME94179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MED.LICENSE",
            "identifier": "ME94179",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Jungho Shim, M.D.
• Cindy Shimamoto
• William Reed Shimberg, MD
• Jenny Poulin Shimmel, MS,PT
• Eunice Haheun Shin
• Jennifer E Shin, MD
• Shine Counseling Tampa
• Camille Shine, CRNA
• Shining Minds Psychiatry and Wellness Limited Liability Company
• Shining Star Therapy LLC

• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.