Peter K Shin, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95029073 Issued in CA

Practice address

1529 S Westgate Ave
Los Angeles, CA 90025-2898

Phone

(714) 882-0020

NPI assigned

Oct 25, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

National Medical University, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Karpus Medical Group IncGroup PAC ID 3577604883, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sherman Oaks Hospital Hospital, Sherman Oaks, CA, CCN 050755
• Encino Hospital Medical Center Hospital, Encino, CA, CCN 050158

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Karpus Medical Group Inc

  • General Practice Physician
  • Woodland Hills, CA
  • NPI 1902130016
  Medicare reassignment Care Compare group NPD

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

• Prime Healthcare Services - Sherman Oaks, LLC

  • General Acute Care Hospital
  • Sherman Oaks, CA
  • NPI 1750491247
  Care Compare affiliation
• Prime Healthcare Services Encino LLC

  • General Acute Care Hospital
  • Encino, CA
  • NPI 1437322377
  Care Compare affiliation

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1689950438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 S WESTGATE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252898",
            "telephone_number": "714-882-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 S WESTGATE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252898",
            "telephone_number": "714-882-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "PETER",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-25",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95029073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Elena Shin
• Mika Shin
• Min Ji Shin
• Mira Shin, L.AC.
• Patrick Shin, PHARM.D.
• Priscilla Shin
• Rachel Shin, MD MPH
• Rebecca Shin
• Ruby Shin, MS, OTR/L
• Sally Min Shin, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.