Active NPI
Beverly Hyonmi Shin, M.D.
- Addiction Psychiatry Physician
- New York, NY
National Provider Identifier
1801321351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Psychiatry Physician
- License
- 296088-01
- Practice address
- 50 E 72ND St Ste 1a
New York, NY 10021-4246 - Phone
- (212) 879-0561
- Fax
- (574) 319-7299
- NPI assigned
- Apr 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 296088-01 | NY | Primary |
Addresses
Primary practice location
50 E 72ND St Ste 1a
New York, NY 10021-4246
Mailing address
50 E 72ND St Ste 1a
New York, NY 10021-4246
Phone (212) 879-0561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 24, 2022 through Sep 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 296088-01 | NY | MD | Addiction Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675641600000",
"number": "1801321351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 E 72ND ST STE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214246",
"telephone_number": "212-879-0561",
"fax_number": "574-319-7299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 E 72ND ST STE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214246",
"telephone_number": "212-879-0561",
"fax_number": "574-319-7299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "BEVERLY",
"middle_name": "HYONMI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-21",
"last_updated": "2023-02-06",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "NY",
"license": "296088-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.