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MR. YONGDEOK BRUCE SHIN DO
NPI 1033812722
Internal Medicine in Roanoke, VA

Active since March 23, 2023PECOS EnrolledAccepts Medicare Assignment
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014(540) 981-7000(540) 853-0931 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 19, 2026, Mar 23, 2023 (2 updates tracked since 2023).

About Mr. Yongdeok Bruce Shin Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. YONGDEOK BRUCE SHIN DO (NPI 1033812722) is an individual internal medicine provider in Roanoke, Virginia, licensed in Virginia (0102209167) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Mary Washington Hospital, and maintains a secondary practice location in Fredericksburg.

NPPES Registry Identity

NPI1033812722
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMR. YONGDEOK BRUCE SHINCredential: DO
Location Address1906 BELLEVIEW AVE SERoanoke, VA 24014-1838
Mailing Address213 S Jefferson St Ste 1006Roanoke, VA 24011-1713 · (540) 224-5516
Phone(540) 981-7000
Fax(540) 853-0931
Sole ProprietorNo
Medical School CMSEdward Via Col Of Osteo Medicine-virginia CampusGraduated 2023
Enumeration DateMarch 23, 2023
Last NPPES UpdateMay 19, 20262 updates tracked since enumeration
NPPES CertifiedMay 19, 2026
✔ NPI 1033812722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in VA · 0102209167
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1906 BELLEVIEW AVE SE, Roanoke, VA 24014
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Secondary Practice Location 1

Location 11001 Sam Perry Blvd, MWHC Internal Medicine GMEFredericksburg, VA 22401 · Phone (540) 741-1451

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Yongdeok Bruce Shin Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517327927
PECOS Enrollment IDI20260603003918
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

5

Medicare enrollment records show Yongdeok Shin reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carilion Medical Center
Same address
Multi-Specialty
1906 BELLEVIEW AVE SE
Roanoke, VA 24014
  • Reassigned Medicare billing, Virginia enrollment
  • 1,207 clinicians in this Medicare group
NPI 1730123472 (540) 981-7000
Carilion Healthcare Corporation
1.4 mi
Multi-Specialty
213 S JEFFERSON ST STE 1006
Roanoke, VA 24011
  • Reassigned Medicare billing, Virginia enrollment
  • 956 clinicians in this Medicare group
NPI 1447206370 (540) 224-5452
Carilion Giles Community Hospital
11 mi
Rural Health
22890 VIRGIL GOODE HWY.
Boones Mill, VA 24065
  • Reassigned Medicare billing, Virginia enrollment
  • Also billed through NPI 1023663267 (Virginia)
  • 608 clinicians in this Medicare group
NPI 1154948271 (540) 334-5511
Carilion Rockbridge Community Hospital
22 mi
Rural Health
18080 MAIN ST
Buchanan, VA 24066
  • Reassigned Medicare billing, Virginia enrollment
  • Also billed through NPI 1942854427 (Virginia)
  • 507 clinicians in this Medicare group
NPI 1144848003 (540) 254-1239
Mary Washington Healthcare Providers LLC
153 mi
Hospitalist
1001 SAM PERRY BLVD
Fredericksburg, VA 22401
  • Reassigned Medicare billing, Virginia enrollment
  • 323 clinicians in this Medicare group
NPI 1750826277 (540) 741-1821

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mary Washington Hospital

Acute Care Hospitals · Fredericksburg, VA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490022
Location1001 Sam Perry BoulevardFredericksburg, VA 22401 · Fredericksburg City County
Emergency services Birthing friendly

Carilion Medical Center

Acute Care Hospitals · Roanoke, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490024
Location1906 Belleview Avenue, SERoanoke, VA 24014 · Roanoke City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24014 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN K THOMPSON PA-C, ATC
Physician Assistant
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. JAMES LIGHT MD
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
SUJINA PRADHAN M.D.
Family Medicine
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. SAMMY ZAKI ELSARRAG M.D.
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NIMA JAHROMI DO
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
TAYLOR ALEXIS KEYS
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NATHAN WILLIAM WAKEFIELD
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
ASHLYN BROOKE CONRAD
Nurse Practitioner
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yongdeok Shin's NPI number?

The NPI number for Yongdeok Shin is 1033812722. It was assigned to this individual provider in the NPPES registry on March 23, 2023.

Where is Yongdeok Shin located?

Yongdeok Shin practices at 1906 Belleview Ave SE, Roanoke, VA 24014. The listed phone number is (540) 981-7000.

What is Yongdeok Shin's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Yongdeok Shin enrolled in Medicare?

Yes. Yongdeok Shin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Yongdeok Shin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Yongdeok Shin reassigns Medicare benefits to 5 organizations: Carilion Medical Center (Roanoke, VA), Carilion Healthcare Corporation (Roanoke, VA), Carilion Giles Community Hospital (Boones Mill, VA), Carilion Rockbridge Community Hospital (Buchanan, VA) and Mary Washington Healthcare Providers LLC (Fredericksburg, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Yongdeok Shin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Yongdeok Shin affiliated with any hospitals?

According to CMS data, Yongdeok Shin is affiliated with Mary Washington Hospital and Carilion Medical Center.

When was this NPI record last updated?

The NPPES record for Yongdeok Shin was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.