Individual provider Active NPI

Silas Hyun Seok Shin, DO

  • Family Medicine Physician
  • Bloomfield, IA
National Provider Identifier
1740847045
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-06590 Issued in IA
Practice address
509 N Madison St
Bloomfield, IA 52537-1299
Phone
(434) 799-4488
NPI assigned
May 22, 2019
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DO-06590 IA Primary

Addresses

Primary practice location

509 N Madison St
Bloomfield, IA 52537-1299

Mailing address

509 N Madison St
Bloomfield, IA 52537-1299
Phone (641) 664-3832

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address silas.shin@davis.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240318002957 IA Practitioner - Family Practice 8921431537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis County HospitalGroup PAC ID 3971493040, shared by 4 NPIs, 14 clinicians

Practice addresses (Care Compare)

509 N Madison St
Bloomfield, IA 52537-1271
Phone (641) 664-2145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-06590IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Davis County Hospital CurrentSince Feb 12, 2024 Accepting new patients
Davis County Hospital CurrentSince Feb 12, 2024 Accepting new patients
Davis County Hospital Current Accepting new patients
Davis County Hospital Past Accepting new patients

Locations

509 N Madison St
Bloomfield, IA 52537
Phone (641) 664-2145

509 N Madison St
Ste 100
Bloomfield, IA 52537
Phone (641) 664-3832

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/639e10d5-cd9b-4520-ac16-cab58cec3fc7/
  • Direct secure messaging: silas.shin@davis.cernerdirect.com

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 2

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": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1740847045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N MADISON ST",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525371299",
            "telephone_number": "641-664-3832",
            "fax_number": "641-664-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N MADISON ST",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525371299",
            "telephone_number": "434-799-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SILAS",
        "middle_name": "HYUN SEOK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-06590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "silas.shin@davis.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Davis County Hospital & Clinics Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "509 N Madison St",
            "city": "Bloomfield",
            "state": "IA",
            "country_code": "US",
            "postal_code": "525371299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomfield, IA

Sources for this page

Verify at the official NPI Registry.