NPIMap

Individual provider Active NPI

Edward J. Shin, MD

  • Otolaryngology Physician
  • New York, NY
National Provider Identifier
1962445197
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
224219 Issued in NY
Practice address
128 Mott St
Room 608
New York, NY 10013-5540
Phone
(212) 343-8399
Fax
(212) 343-1386
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 224219 NY Primary

Addresses

Primary practice location

128 Mott St
Room 608
New York, NY 10013-5540

Mailing address

PO Box 2625
New York, NY 10009-8925
Phone (212) 979-4572

Other identifiers 1

IdentifierTypeStateIssuer
02366989MedicaidNY

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
I20040322001930 NY Practitioner - Otolaryngology 5496646143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Stanford University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

310 E 14TH St
New York, NY 10003-4284
Phone (212) 614-8288

Hospital & facility affiliations

  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169
  • Ny Eye and Ear Infirmary of Mount Sinai Hospital, New York, NY, CCN 330100
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 7, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Otolaryngology CurrentSince Dec 7, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
ENT and Allergy Associates LLP Otolaryngology PastSince Apr 20, 1998 Accepting new patients
Physician Associates of Nyeei, LLC PastSince Aug 1, 2002 Accepting new patients
Gregory Levitin MD PC Otolaryngology Past Accepting new patients

Locations

310 E 14th St
Fl 6
New York, NY 10003
Phone (212) 979-4200

310 E 14th St
#1
New York, NY 10003

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

10 Union Sq E
Ste 5D
New York, NY 10003
Phone (212) 844-6354

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

Networks

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

Interoperability endpoints

  • Direct secure messaging: eshin@direct.nyee-provider.mountsinai.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1962445197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2625",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100098925",
            "telephone_number": "212-979-4572",
            "fax_number": "212-979-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MOTT ST",
            "address_2": "ROOM 608",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135540",
            "telephone_number": "212-343-8399",
            "fax_number": "212-343-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "EDWARD",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "224219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02366989",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.