Sang O Shin, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD2013-0642 Issued in NM

Practice address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5180

Phone

(265) 171-1505

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Clark Fork Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Missoula, MT
  • NPI 1538384987
  NPD (past)
• Doctors Medical Services, Emcare

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1578850962
  NPD (past)
• Nevada Em-I Silver-Homansky Medical Services Professional Corporation

  • Emergency Medicine Physician
  • Pahrump, NV
  • NPI 1881932721
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1649226440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MADISON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871106214",
            "telephone_number": "505-239-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085180",
            "telephone_number": "265-171-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SANG",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-9682",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "11099",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "10564",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2013-0642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Shike, MS CCC-SLP
• Megan Jennifer Shilvock, M.A. LMHC
• Christie Julie Shin
• Harold Dongjin Shin
• Peter C. Shin, M.D.
• Mara Esther Shindell, D.D.S.
• Amal Shine, MD
• Phyllis Shingle, LCSW
• Mary Ann Shinnick, LISW
• Justin Lane Shipler

• Emergency Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Emergency Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.