Individual provider Active NPI

Wonsock Shin, M.D.

  • Internal Medicine Physician
  • Vienna, VA
National Provider Identifier
1821098203
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0055325 Issued in MD
Practice address
410 Pine St SE
Suite 200
Vienna, VA 22180-4861
Phone
(703) 865-8615
Fax
(301) 777-7455
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0055325 MD Primary

Addresses

Primary practice location

410 Pine St SE
Suite 200
Vienna, VA 22180-4861

Mailing address

410 Pine St SE
Suite 200
Vienna, VA 22180-4861
Phone (703) 865-8615

Other identifiers 1

IdentifierTypeStateIssuer
226305000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20140430001263 DC Practitioner - Internal Medicine 3577611938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14139 Robert Paris CT
Chantilly, VA 20151-4201
Phone (703) 865-8615

410 Pine St SE
Suite 200
Vienna, VA 22180-4861
Phone (703) 865-8615

Hospital & facility affiliations

  • Inova Home Health LLC Home health agency, Fairfax, VA, CCN 497008

Merit-based Incentive Payment System (MIPS)

Final score
94.4 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
81.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0055325MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wonsock Shin MD, LLC Internal Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

925 Bishop Walsh Rd
Cumberland, MD 21502
Phone (301) 759-3800

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": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1821098203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PINE ST SE",
            "address_2": "SUITE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804861",
            "telephone_number": "703-865-8615",
            "fax_number": "301-777-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PINE ST SE",
            "address_2": "SUITE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804861",
            "telephone_number": "703-865-8615",
            "fax_number": "301-777-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "WONSOCK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0055325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226305000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.