Sook-Ja Shin, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A37091 Issued in CA

Practice address

1805 Medical Center Dr
San Bernardino, CA 92411-1217

Phone

(909) 887-6333

Fax

(909) 806-1017

NPI assigned

May 27, 2006

Last updated

Apr 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Anesthesiology

Education

Other, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Springs Anesthesia Services PCGroup PAC ID 6406049592, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital of San Bernardino Hospital, San Bernardino, CA, CCN 050089

Merit-based Incentive Payment System (MIPS)

Final score

84.5 of 100Reported as group

Quality

70

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Palm Springs Anesthesia Services, PC

  • Anesthesiology Physician
  • San Bernardino, CA
  • NPI 1083928501
  Medicare reassignment Care Compare group NPD

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

• Community Hospital of San Bernardino

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1235290818
  Care Compare affiliation

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1881641892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 EL NITA LN",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925444603",
            "telephone_number": "951-929-6260",
            "fax_number": "951-765-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 MEDICAL CENTER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111217",
            "telephone_number": "909-887-6333",
            "fax_number": "909-806-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SOOK-JA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A37091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A370910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Azer Shenouda, DMD
• Wilma Leardean Shepard, LCSW
• Nathan Shepherd
• Kenneth Lemelle Sherrill Jr.
• Myung Shik Shin, DDS
• Trinity M Shofner
• Jasmine La'Rae Shorter
• Dajuan Shorts Jr.
• Shuang Bai, M.D. Inc.
• Alesia Linette Shumate

• Anesthesiology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.