Jae Yoon Shin DPM P.C.

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

JAE YOON SHIN DPM P.C.

Practice address

283 Leonard PL
Paramus, NJ 07652-4517

Phone

(267) 269-7127

NPI assigned

Feb 1, 2022

Last updated

Feb 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jae Yoon Shin, DPMNPI 1396088803

Title

Owner

Phone

(267) 269-7127

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jae Yoon Shin, D.P.M.

  • Podiatrist
  • Long Island City, NY
  • NPI 1396088803

  NJ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1760135636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 27TH ST APT 515",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111018618",
            "telephone_number": "267-268-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 LEONARD PL",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524517",
            "telephone_number": "267-269-7127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Brinkerhoff Ter # 202",
            "address_purpose": "LOCATION",
            "city": "Palisades Park",
            "state": "NJ",
            "postal_code": "076501101",
            "country_code": "US",
            "telephone_number": "267-269-7127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Cranbury Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "East Brunswick",
            "state": "NJ",
            "postal_code": "088164000",
            "country_code": "US",
            "telephone_number": "267-269-7127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4220 27th St Apt 515",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "111018618",
            "country_code": "US",
            "telephone_number": "267-268-7127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAE YOON SHIN DPM P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "JAE",
        "authorized_official_middle_name": "YOON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-269-7127",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepa Jacob, APN
• Merin Thomas Jacob, ANP-C
• Tony Jacob, PA-C
• Stephen Howard Jacobs, M.D.
• Adina Kwestel Jacobson, DPT
• Zahra Batool Jafary, MD
• Summer Jaffrey, M.D.
• Carolyn F Jaime, LCSW
• Jandee Anesthesiology
• Janice Jang, MD

• Podiatric Clinic/Center in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Podiatric Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.