Organization Active NPI

Hyon Christopher Shin, M.D., P.a.

  • Surgery Physician
  • Austin, TX
National Provider Identifier
1871741900
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
HYON CHRISTOPHER SHIN, M.D., P.A.
Practice address
9011 Mountain Ridge Dr Ste 140
Austin, TX 78759-7369
Phone
(512) 443-5954
Fax
(512) 326-3433
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Authorized official

Name
Hyon-Ho Christopher Shin, M.D.
Title
Owner
Phone
(512) 443-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

9011 Mountain Ridge Dr Ste 140
Austin, TX 78759-7369

Mailing address

9011 Mountain Ridge Dr Ste 140
Austin, TX 78759-7369
Phone (512) 443-5954

Other identifiers 2

IdentifierTypeStateIssuer
354064301MedicaidTX
0007WKOtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101122000603 TX Part B Supplier - Clinic/Group Practice 3577759158 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX; Bastrop, TX

National Provider Directory

National Provider Directory

Locations

9011 Mountain Ridge Dr
Ste 140
Austin, TX 78759
Phone (512) 443-0920

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1871741900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 MOUNTAIN RIDGE DR STE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787597369",
            "telephone_number": "512-443-5954",
            "fax_number": "512-326-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9011 MOUNTAIN RIDGE DR STE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787597369",
            "telephone_number": "512-443-5954",
            "fax_number": "512-326-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYON CHRISTOPHER SHIN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "HYON-HO",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-443-5954",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354064301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0007WK",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.