Benjamin Seungchul Shin, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

174390 Issued in CA

Practice address

520 S la Fayette Park PL Ste 300
Los Angeles, CA 90057-5400

Phone

(213) 252-2100

Fax

(213) 252-2199

NPI assigned

Nov 24, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of California, Geffen School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Special Service for Groups IncGroup PAC ID 2769396886, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: btom369514@direct.llu.edu

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.

• Special Service for Groups, Inc.

  • Voluntary or Charitable Agency
  • Los Angeles, CA
  • NPI 1952442949
  Medicare reassignment Care Compare group NPD
• Special Service for Groups, Inc.

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1639391410
  NPD
• Special Service for Groups, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1982735932
  NPD

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1740654078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900575400",
            "telephone_number": "213-252-2100",
            "fax_number": "213-252-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900575400",
            "telephone_number": "213-252-2100",
            "fax_number": "213-252-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "BENJAMIN",
        "middle_name": "SEUNGCHUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-24",
        "last_updated": "2023-10-24",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.071701",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "174390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shin MRI LLC
• Shin Wook Kang Medical Center Inc
• Ahran Shin, M.A.
• Andrea Sunae Shin, MD
• Ann Shin, OTR/L
• Berthold Shin, DO
• Bo Kyong Shin, DPM
• Bonja Shin, LAC
• Cathy Eun-Young Shin, MD
• Crystal Shin, LVN

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.