Ethan Shim, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

47765 Issued in AZ

Practice address

9225 N 3Rd St
Suite 304
Phoenix, AZ 85020

Phone

(602) 445-0751

Fax

(602) 424-8128

NPI assigned

Aug 3, 2009

Sex

Male

Sole proprietor

No

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 AZ

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

Internal Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affiliated Hospitalists PLCGroup PAC ID 6204822869, 84 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Affiliated Hospitalists, PLC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1265546261

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Honorhealth

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  NPD (past)
• Hospitalist Medicine Physicians of Virginia LLC

  • Internal Medicine Physician
  • Winchester, VA
  • NPI 1770756991
  NPD (past)

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

• Honorhealth

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1750512158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 N 3RD ST",
            "address_2": "SUITE 304",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85020",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 N 3RD ST",
            "address_2": "SUITE 304",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85020",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIM",
        "first_name": "ETHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-03",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "47765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "822711",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly A Shill, M.D.
• Luke Shillig, DC
• Melissa Faye Shilling, LCSW
• Tiffany Amber Shilling, APRN
• Christina M Shim, NP
• Roy D Shim, D.D.S.
• Sara R Shimmin, M.D.
• Timothy Shimon, MD
• Agnes I Shin, PHARMD
• Chan Ho Shin, MD

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.