NPIMap

Individual provider Active NPI

Kevin Seung Joon Shin

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1669095741
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A22149 Issued in CA
Practice address
300 Hillmont Ave
BLDG 340, Ste 101 & 201
Ventura, CA 93003-1651
Phone
(805) 652-6100
NPI assigned
May 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0227314 OR
Family Medicine Physician 207Q00000X 20A22149 CA Primary

Addresses

Primary practice location

300 Hillmont Ave
BLDG 340, Ste 101 & 201
Ventura, CA 93003-1651

Mailing address

300 Hillmont Ave
BLDG 340, Ste 101 & 201
Ventura, CA 93003-1651
Phone (805) 652-6100

Other practice location 1

801 Cooper Rd
Oxnard, CA 93030-5445
Phone (805) 330-8100

Other practice location 2

525 N Santiam Hwy
Lebanon, OR 97355-4363
Phone (541) 258-2101

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kshin339011@samhealth.direct-ci.com
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240502003542 CA Practitioner - Family Practice 7315387651 Reassigns benefits to 5 organizations
I20251211001675 OR Practitioner - Family Practice 7315387651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Col of Osteo Med of the Pacific at Lebanon, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

300 Hillmont Ave
Ventura, CA 93003-1651

4949 Market St
Ventura, CA 93003-7851
Phone (877) 608-0044

888 S Hill Rd
Ventura, CA 93003-8400
Phone (805) 477-6400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A22149CAMDFamily Medicine Physician
D0227314ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince May 13, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Dec 9, 2025 Accepting new patients
Clinicas del Camino Real Inc CurrentSince May 13, 2024 Accepting new patients
County of Ventura CurrentSince Jun 5, 2024 Accepting new patients
County of Ventura CurrentSince Jun 5, 2024 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Dec 9, 2025 Accepting new patients
Sutter Valley Medical Foundation CurrentSince May 19, 2024 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Dec 9, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 29, 2025 Accepting new patients
American Specialty Physicians Group Inc CurrentSince Jul 18, 2024 Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
County of Ventura Current Accepting new patients
Sutter Valley Medical Foundation Family Medicine CurrentSince May 19, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 29, 2025 Accepting new patients

Locations

151 E Webster St
Ste B
Colusa, CA 95932
Phone (209) 287-6308

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

240 Spruce St
Gridley, CA 95948
Phone (530) 846-5671

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

700 17th St
Ste 205
Modesto, CA 95354
Phone (209) 248-7851

801 Cooper Rd
Oxnard, CA 93030
Phone (805) 330-8100

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

800 S Victoria Ave
#L4640
Ventura, CA 93009

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

525 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 258-2101

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

Interoperability endpoints

  • Direct secure messaging: kshin683263@hisp.ehr.sutterhealth.org
  • Direct secure messaging: kshin339011@samhealth.direct-ci.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1669095741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "address_2": "BLDG 340, STE 101 & 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "address_2": "BLDG 340, STE 101 & 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Cooper Rd",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930305445",
            "country_code": "US",
            "telephone_number": "805-330-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 N Santiam Hwy",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973554363",
            "country_code": "US",
            "telephone_number": "541-258-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "KEVIN",
        "middle_name": "SEUNG JOON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "D0227314",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A22149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshin339011@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "525 N Santiam Hwy",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973554363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.