Chang B. Shin, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD00018197 Issued in WA

Practice address

4300 Talbot Rd S
Suite 303
Renton, WA 98055-6238

Phone

(425) 228-7446

Fax

(425) 277-4746

NPI assigned

Mar 26, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

NeurologyAlso: General Practice

Education

University of Texas Medical School at San Antonio, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Painless Clinic PLLC

  • Neurology Physician
  • Renton, WA
  • NPI 1477204295
  Medicare reassignment NPD Authorized official
• Eric T Waterman MD, PLLC

  • Otolaryngology Physician
  • Renton, WA
  • NPI 1215180864
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730207143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 TALBOT RD S",
            "address_2": "SUITE 303",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556238",
            "telephone_number": "425-228-7446",
            "fax_number": "425-277-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 TALBOT RD S",
            "address_2": "SUITE 303",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556238",
            "telephone_number": "425-228-7446",
            "fax_number": "425-277-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "CHANG",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD00018197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "129032",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexey Shikuev, MD
• Micah M Shimabuku, PT
• Heather Teruko Shimamoto, PHARM.D.
• Teresa Shimizu, PT
• Ally J Shin, ARNP
• SE Jung Shin, M.D.
• Garth Shippen, LO
• Hafsa Shire
• Galina Shkinder
• James Franklin Shockley Jr.

• Neurology Physician in Renton, WA
• Providers in Renton, WA by specialty
• Neurology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.