NPIMap

Individual provider Active NPI

Charles Y Jin, MD

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1801966924
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
222414 Issued in NY
Practice address
MMC - Psyc. Observation Serv.
111 E. 210TH Street
Bronx, NY 10467
Phone
(718) 920-7460
NPI assigned
Nov 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 222414 NY Primary

Addresses

Primary practice location

MMC - Psyc. Observation Serv.
111 E. 210TH Street
Bronx, NY 10467

Mailing address

400 Community Dr
Manhasset, NY 11030-3815
Phone (718) 920-7460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA, DE, TX, MS5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20050106000725 NY Practitioner - Psychiatry 1658329693 Reassigns benefits to 1 organization
I20120202000434 PA Practitioner - Addiction MedicinePractitioner - Psychiatry 1658329693 Reassigns benefits to 2 organizations
Practice locations: West Chester, PA
I20171019001265 DE Practitioner - Psychiatry 1658329693 Reassigns benefits to 1 organization
I20221109001500 TX Practitioner - Psychiatry 1658329693 Reassigns benefits to 1 organization
I20250506001908 MS Practitioner - Psychiatry 1658329693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TBD Acquisition II LLCGroup PAC ID 7911272257, 5 clinicians
The Mind and Body Consortium, LLC.Group PAC ID 9739234014, 19 clinicians

Practice addresses (Care Compare)

11150 Hwy 49
Gulfport, MS 39503-4110
Phone (228) 831-1700

1204 Seward Ave
Searhc 1204 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1206 Seward Ave
Searhc 1206 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1209 Seward Ave
Searhc 1209 Behavioral
Sitka, AK 99835-7359
Phone (907) 966-8611

156 S State St
Dover, DE 19901-7314
Phone 302674238039

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

227 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222414NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TBD Acquisition II, LLC CurrentSince Mar 2, 2025 Accepting new patients
Montefiore Medical Center Psychiatry CurrentSince Aug 3, 2021 Accepting new patients
Human Services, Inc. CurrentSince Aug 27, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Aug 3, 2021 Accepting new patients
Human Services, Inc Current Accepting new patients
The Mind and Body Consortium, LLC. Psychiatry CurrentSince Aug 15, 2017 Accepting new patients
Merakey Delaware County CurrentSince Feb 8, 2017 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 26, 2022 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 26, 2022 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Merakey Delaware County CurrentSince Feb 8, 2017 Accepting new patients
TBD Acquisition II LLC CurrentSince Mar 2, 2025 Accepting new patients
Noah D Freedman MD PC Psychiatry PastSince Nov 5, 2007 Accepting new patients
Shortridge Academy Past Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

156 S State St
Dover, DE 19901
Phone 30267423801218

118 Sandhill Dr
Ste 201
Middletown, DE 19709
Phone 3024499314108

11150 Highway 49
Gulfport, MS 39503
Phone (228) 575-1000

111 E 210th St
Bronx, NY 10467

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

620 Germantown Pike
Lafayette Hl, PA 19444
Phone (313) 278-2327

800 Chester Pike
Sharon Hill, PA 19079
Phone (610) 534-3636

50 James Buchanan Rd
Thorndale, PA 19372
Phone (610) 200-6222

Interoperability endpoints

  • Direct secure messaging: cjin@direct-searhc.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801966924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303815",
            "telephone_number": "718-920-7460",
            "fax_number": "718-515-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - PSYC. OBSERVATION SERV.",
            "address_2": "111 E. 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "CHARLES",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "222414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.