Sung Ryan Shin, PA-C, DHSC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110003258 Issued in VA

Practice address

6858 Old Dominion Dr Ste 102
MC Lean, VA 22101-3832

Phone

(703) 847-9800

NPI assigned

Mar 2, 2010

Sex

Male

Sole proprietor

No

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 DC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Inova Ucc LLC

  • Urgent Care Clinic/Center
  • Vienna, VA
  • NPI 1508592114

  DC

  Medicare reassignment
• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1003090879

  DC

  Medicare reassignment
• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1780868547

  VA

  Medicare reassignment
• Centreville Internal Medicine

  • Adult Day Care Clinic/Center
  • Centreville, VA
  • NPI 1073712352
  NPD (past)
• International Medical Center, Inc

  • General Practice Physician
  • Springfield, VA
  • NPI 1265685515
  NPD (past)
• King George Medical Center LTD

  • Family Medicine Physician
  • Dahlgren, VA
  • NPI 1043252802
  NPD (past)

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1912220112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 FARR OAK CIR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302438",
            "telephone_number": "571-235-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6858 OLD DOMINION DR STE 102",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013832",
            "telephone_number": "703-847-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5249 Duke St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223042907",
            "country_code": "US",
            "telephone_number": "703-658-2650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SUNG",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "PA-C, DHSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083533",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Allison Shelton, PSY.D.
• Milagros Rocio Shepard, PA-C
• Trushita Sheth, PT
• Michael Shiau, DDS
• Jeanne W Shiffman, M.D.
• Julia W Shiner, M.D.
• Christiane Shipley, LPC
• Valia Shoja, RESIDENT LPC
• Shore Armani MD PC
• Catherine Shores, OTR/L

• Physician Assistant in McLean, VA
• Providers in McLean, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.