Individual provider Active NPI

Hyonah Shin, M.D.

  • Emergency Medicine Physician
  • Paradise, CA
National Provider Identifier
1902810559
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A99779 Issued in CA
Practice address
5974 Pentz Rd
Paradise, CA 95969-5509
Phone
(530) 877-9361
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 231746 NY
Emergency Medicine Physician 207P00000X A99779 CA Primary

Addresses

Primary practice location

5974 Pentz Rd
Paradise, CA 95969-5509

Mailing address

2100 Powell St
Suite 920
Emeryville, CA 94608-1826
Phone (510) 350-2673

Other identifiers 1

IdentifierTypeStateIssuer
00A99790MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071017000531 CA Practitioner - Emergency MedicinePractitioner - Family Practice 5092781674 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99779CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Oct 4, 2022 Accepting new patients
Vallejo Emergency Physicians Medical Group Inc. Emergency Medicine CurrentSince Jun 1, 2016 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 1, 2010 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 1, 2010 Accepting new patients
Permanente Medical Group Inc Emergency Medicine CurrentSince Oct 4, 2022 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Permanente Medical Group Inc Emergency Medicine Current Accepting new patients
Central California Radiology Associates Inc Past Accepting new patients
Sierra Rural Physicians, Inc. Emergency Medicine Past Accepting new patients

Locations (25 of 26)

4501 Sand Creek Rd
Antioch, CA 94531
Phone (925) 813-6420

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

5974 Pentz Rd
Paradise, CA 95969
Phone (530) 872-2000

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

Organizations & group practices 9

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1902810559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5974 PENTZ RD",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959695509",
            "telephone_number": "530-877-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "HYONAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "231746",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A99779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A99790",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Sand Creek Rd",
            "city": "Antioch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945318687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paradise, CA

Sources for this page

Verify at the official NPI Registry.