NPIMap

Individual provider Active NPI

David S Shin, MD

  • Surgery Physician
  • Mineola, NY
National Provider Identifier
1871788703
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
237870 Issued in NY
Practice address
300 Old Country Rd
Suite 101
Mineola, NY 11501-4112
Phone
(516) 741-4138
Fax
(516) 294-4301
NPI assigned
Sep 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 237870 NY Primary

Addresses

Primary practice location

300 Old Country Rd
Suite 101
Mineola, NY 11501-4112

Mailing address

300 Old Country Rd
Suite 101
Mineola, NY 11501-4112
Phone (516) 741-4138

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dshin238895@nyumc.direct-ci.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080617000134 NY Practitioner - General Surgery 4789755935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)51
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University Surgery CurrentSince Oct 1, 2018 Accepting new patients
NYU Langone Hospitals Past Accepting new patients
Nyumc Radiology Associates Past Accepting new patients
Winthrop Community Medical Affiliates PC Surgery Past Accepting new patients

Locations

1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

300 Old Country Rd
Ste 101
Mineola, NY 11501
Phone (516) 400-2988

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: dshin238895@nyumc.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1871788703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD",
            "address_2": "SUITE 101",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014112",
            "telephone_number": "516-741-4138",
            "fax_number": "516-294-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD",
            "address_2": "SUITE 101",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014112",
            "telephone_number": "516-741-4138",
            "fax_number": "516-294-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "237870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshin238895@nyumc.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "300 Old Country Rd",
            "address_2": "Suite 101",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.