NPIMap

Individual provider Active NPI

Tae Min Shin, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Los Angeles, CA
National Provider Identifier
1750483723
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G85170 Issued in CA
Practice address
1245 Wilshire Blvd., Suite 400
Los Angeles, CA 90017
Phone
(213) 482-2992
Fax
(213) 482-2999
NPI assigned
Sep 1, 2006
Last updated
Apr 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X G85170 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd., Suite 400
Los Angeles, CA 90017

Mailing address

1245 Wilshire Blvd Ste 400
Los Angeles, CA 90017-4810
Phone (213) 482-2992

Other identifiers 1

IdentifierTypeStateIssuer
00G851700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070524000222 CA Practitioner - Orthopedic Surgery 6901903061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Yale University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Angeles Orthopaedic Center Medical GroupGroup PAC ID 8224026133, 4 clinicians
Pacifica Foundation LLCGroup PAC ID 0648624718, 5 clinicians

Practice addresses (Care Compare)

1245 Wilshire Blvd
Suite 400
Los Angeles, CA 90017-4814
Phone (213) 482-2992

1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone (323) 627-4874

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.78
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Spinal fusion80
Laminectomy or laminotomy (partial removal of spine bones)49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85170CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Orthopaedic Center Medical Group Orthopaedic Surgery CurrentSince Aug 1, 2003 Accepting new patients
Lawrence D. Dorr, M.D., Inc. Past Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

1245 Wilshire Blvd
Ste 200
Los Angeles, CA 90017
Phone (213) 482-2992

1245 Wilshire Blvd
Ste 400
Los Angeles, CA 90017
Phone (213) 482-2992

1245 Wilshire Blvd
Ste 804
Los Angeles, CA 90017
Phone (213) 482-2992

1441 Huntington Dr
South Pasadena, CA 91030

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pacificafoundation.taeshin@157113.advancedmd-direct.com
  • Direct secure messaging: taeshin@laocsmmg.allscriptsdirect.net

Organizations & group practices 5

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 9

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1750483723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-482-2992",
            "fax_number": "213-482-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD., SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-482-2992",
            "fax_number": "213-482-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "TAE",
        "middle_name": "MIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G85170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G851700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.