Individual provider Active NPI

Victoria Shim, DO

  • Psychiatry Physician
  • Albany, NY
National Provider Identifier
1750886347
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
310373 Issued in NY
Practice address
47 New Scotland Avenue
Dept. of Psychiatry
Albany, NY 12208
Phone
(518) 262-5511
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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 64086
Psychiatry Physician 2084P0800X 310373 NY Primary

Addresses

Primary practice location

47 New Scotland Avenue
Dept. of Psychiatry
Albany, NY 12208

Mailing address

47 New Scotland Avenue
Dept. of Psychiatry
Albany, NY 12208

Other practice location 1

1300 Massachusetts Ave
Troy, NY 12180-1628
Phone (518) 268-5542

Other practice location 2

64 2nd Ave
Albany, NY 12202-1240
Phone (518) 449-5170

Other practice location 3

315 S Manning Blvd Ste 6408A
Albany, NY 12208-1707
Phone (518) 525-1303

Other practice location 4

3 Mercycare Ln
Guilderland, NY 12084-3504
Phone (518) 452-6700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220622001258 NY Practitioner - Psychiatry 5799021341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rowan University School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters Hospital of the City of AlbanyGroup PAC ID 2668460072, 268 clinicians

Practice addresses (Care Compare)

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

Hospital & facility affiliations

  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310373NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
St. Peter'S Hospital of the City of Albany Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
Samaritan Hospital of Troy, New York Psychiatry CurrentSince Aug 1, 2022 Accepting new patients

Locations

315 S Manning Blvd
Ste 6408A
Albany, NY 12208
Phone (518) 525-1301

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

64 2nd Ave
Albany, NY 12202
Phone (518) 449-5170

3 Mercycare Ln
Guilderland, NY 12084
Phone (518) 452-6700

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1750886347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVENUE",
            "address_2": "DEPT. OF PSYCHIATRY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVENUE",
            "address_2": "DEPT. OF PSYCHIATRY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-262-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-268-5542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "64 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122021240",
            "country_code": "US",
            "telephone_number": "518-449-5170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd Ste 6408A",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Mercycare Ln",
            "address_purpose": "LOCATION",
            "city": "Guilderland",
            "state": "NY",
            "postal_code": "120843504",
            "country_code": "US",
            "telephone_number": "518-452-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIM",
        "first_name": "VICTORIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "64086",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "310373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd Ste 6408A",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.