Anthony S Shin, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A42601 Issued in CA

Practice address

12000 Mount Vernon Ave
Grand Terrace, CA 92313-5174

Phone

(951) 273-0136

Fax

(951) 848-9121

NPI assigned

Jul 26, 2006

Last updated

May 7, 2020By the provider in NPPES

Sex

Male

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

Psychiatry

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothills Psychological Services IncGroup PAC ID 9436157534, 37 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.

• Foothills Psychological Services, Inc.

  • Psychologist
  • Upland, CA
  • NPI 1336121888

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Mission City Community Network, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hollywood, CA
  • NPI 1710102009

  Single Specialty

  Medicare reassignment NPD
• Mission City Community Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Victorville, CA
  • NPI 1265708994

  Single Specialty

  NPD
• Mission City Community Network, Inc.

  • Community Health Clinic/Center
  • North Hills, CA
  • NPI 1710370747

  Single Specialty

  NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1982628756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 946",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923540946",
            "telephone_number": "951-273-0136",
            "fax_number": "951-848-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135174",
            "telephone_number": "951-273-0136",
            "fax_number": "951-848-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "ANTHONY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A42601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A426010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Yanira Saldana, SLPA
• Betty M Sanabria
• Sarah Frances Sayegh, M.S. SLP
• Hillel Olivier Shand, PHARMD MPH
• Elyssa Lorraine Shaw, ASW11761
• Gerard Joseph Bernal Sim, OD
• Brittney Lynn Singh Young, DPT
• Dilpreet Singh
• Kimberly-Nicolle Valdez Singngam
• Cirselda Aniag Siquian, RN

• Psychiatry Physician in Grand Terrace, CA
• Providers in Grand Terrace, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.