Individual provider Active NPI

Richard D Shin, M.D.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1669783338
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
264929 Issued in NY
Practice address
450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone
(718) 245-3188
NPI assigned
Jun 28, 2010
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 264929 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Brooklyn, NY 11203-2012

Mailing address

724 166TH St
Apt. 4B
Whitestone, NY 11357-2060
Phone (213) 400-7104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20141007002125 NY Practitioner - Emergency Medicine 8729208129 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens Emergency Medical Associates PLLCGroup PAC ID 8325263171, 43 clinicians

Practice addresses (Care Compare)

5645 Main St
Flushing, NY 11355-5045
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coney Island Medical Practice Plan, P.C. CurrentSince Sep 3, 2014 Accepting new patients
Queens Emergency Medical Associates PLLC Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
Suny Health Science Center at Bklyn Emergency Medicine CurrentSince Nov 1, 2014 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Emergency Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 826-4900

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

Interoperability endpoints

  • Direct secure messaging: rds9009@direct.nyp.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1669783338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 166TH ST",
            "address_2": "APT. 4B",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572060",
            "telephone_number": "213-400-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-245-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "RICHARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "264929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.