Individual provider Active NPI

Henry John Shin, DPM

  • Podiatrist
  • National City, CA
National Provider Identifier
1780775379
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4180 Issued in CA
Practice address
2340 E 8TH St
Suite a
National City, CA 91950-2869
Phone
(619) 475-3338
Fax
(619) 267-7977
NPI assigned
Sep 27, 2006
Last updated
Dec 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4180 CA Primary

Addresses

Primary practice location

2340 E 8TH St
Suite a
National City, CA 91950-2869

Mailing address

7249 Calabria CT Unit 62
San Diego, CA 92122-6002
Phone (619) 475-3338

Other identifiers 1

IdentifierTypeStateIssuer
000E41800MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040810000413 CA Practitioner - Podiatry 9739151853 Reassigns benefits to 3 organizations
Practice locations: National City, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone (858) 499-2600

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue297
Removal or shaving of skin growth59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 29, 2009 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 29, 2009 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 19, 2019 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Mar 19, 2019 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Podiatrist CurrentSince Jan 9, 2023 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jan 9, 2023 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Primary Care Physicians of South Bay Medical Group Inc Past Accepting new patients
Paradise Valley Hospital Past Accepting new patients

Locations

16899 W Bernardo Dr
San Diego, CA 92127
Phone (858) 499-2705

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Interoperability endpoints

  • Direct secure messaging: hshin32504@sharphealthcare.direct-ci.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1780775379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7249 CALABRIA CT UNIT 62",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921226002",
            "telephone_number": "619-475-3338",
            "fax_number": "619-267-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E 8TH ST",
            "address_2": "SUITE A",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502869",
            "telephone_number": "619-475-3338",
            "fax_number": "619-267-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "HENRY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E41800",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.