Individual provider Active NPI

James Jung Hyun Shin, MS AUDIOLOGIST

  • Audiologist
  • Los Angeles, CA
National Provider Identifier
1821158668
Registry record updated Feb 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU2108 Issued in CA
Practice address
2727 W Olympic Blvd
Suite 308
Los Angeles, CA 90006-2699
Phone
(213) 380-8618
Fax
(213) 380-2091
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA4050 CA
Audiologist 231H00000X AU2108 CA Primary

Addresses

Primary practice location

2727 W Olympic Blvd
Suite 308
Los Angeles, CA 90006-2699

Mailing address

2727 W Olympic Blvd
Suite 308
Los Angeles, CA 90006-2699
Phone (213) 380-8618

Other identifiers 2

IdentifierTypeStateIssuer
AU0021080MedicaidCA
1821158668MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000369 CA Practitioner - Qualified Audiologist 6608922687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2727 W Olympic Blvd
Suite 308
Los Angeles, CA 90006-2699
Phone (213) 380-8618

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AU2108CAMDAudiologist
HA4050CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Shins Professional Hearing AIDS Inc Audiologist CurrentSince Feb 20, 2011 Accepting new patients
Sos Special Office Services Past Accepting new patients

Locations

12902 Brookhurst St
Ste D
Garden Grove, CA 92840
Phone (714) 534-5678

2727 W Olympic Blvd
Ste 308
Los Angeles, CA 90006
Phone (213) 380-8618

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297555200000",
    "number": "1821158668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 W OLYMPIC BLVD",
            "address_2": "SUITE 308",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062699",
            "telephone_number": "213-380-8618",
            "fax_number": "213-380-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W OLYMPIC BLVD",
            "address_2": "SUITE 308",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062699",
            "telephone_number": "213-380-8618",
            "fax_number": "213-380-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JAMES",
        "middle_name": "JUNG HYUN",
        "credential": "MS AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA4050",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU2108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AU0021080",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821158668",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.