Alice Shin, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

D82874 Issued in MD

Practice address

6501 N Charles St
Baltimore, MD 21204-6819

Phone

(410) 938-3000

NPI assigned

Jun 18, 2014

Last updated

Sep 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jeongwon Shin Other name

Medicare fee-for-service enrollment

Enrolled in PA

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

Psychiatry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pennsylvania Department of Human ServicesGroup PAC ID 0547168064, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Pennsylvania Department of Human Services

  dba Wernersville State Hospital

  • Psychiatric Hospital
  • Wernersville, PA
  • NPI 1497739973
  Medicare reassignment Care Compare group NPD
• Pennsylvania Department of Public Welfare

  dba Allentown State Hospital

  • Psychiatric Hospital
  • Allentown, PA
  • NPI 1386626919
  NPD
• Lifes Energy Wellness Center Inc.

  • Professional Counselor
  • Easton, MD
  • NPI 1316464951
  NPD (past)

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1972917813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 MARYBETH WAY",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436627",
            "telephone_number": "443-492-9885",
            "fax_number": "703-884-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "410-938-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2324 West Zion Rd.",
            "address_2": "Suite 112",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "21801",
            "country_code": "US",
            "telephone_number": "800-867-2395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "514 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MD",
            "postal_code": "216131834",
            "country_code": "US",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8737 Brooks Dr Ste 108",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216017474",
            "country_code": "US",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D82874",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D82874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEONGWON",
            "last_name": "SHIN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aaron Shim, DO
• Jalene Shim, MD
• William Thomas Shimeall, MD MPH
• Megan Eileen Shimkaveg, M.D.
• Eleanor Edith Shimkin-Sorock, M.D.
• Anthony Shin, LCPC
• Baekhyo Shin, M.D.
• Eui Sik Shin, DDS
• Eun Ji Shin, M.D.
• Hyesung Shin

• Child & Adolescent Psychiatry Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Child & Adolescent Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.