SHINE MMG
NPI 1053930248
Family Medicine in Glendale, CA
About Shine Mmg NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHINE MMG (NPI 1053930248) is a healthcare organization registered as a family medicine in Glendale, California and active in the NPI registry since April 2020. The organization lists Emil Golub, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shine Mmg is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Shine Mmg, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (15)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Shine Mmg Inc's NPI number?
The NPI number for Shine Mmg Inc is 1053930248. It was assigned to this organization in the NPPES registry on April 8, 2020. The provider is doing business as Shine Mmg.
Where is Shine Mmg Inc located?
Shine Mmg Inc is located at 450 N Brand Blvd Ste 625A, Glendale, CA 91203. The listed phone number is (818) 745-0070.
What is Shine Mmg Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Shine Mmg Inc enrolled in Medicare?
Yes. Shine Mmg Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shine Mmg Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 2 Medicare specialties reassign their Medicare billing to Shine Mmg Inc. A 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 the clinician's services. The largest specialties are Nurse Practitioner (10) and Emergency Medicine (5). Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Shine Mmg Inc was last updated on April 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Shine Mmg · NPI 1053930248
Family Medicine organization in Glendale, California. Organization record, active in the CMS NPPES registry since April 8, 2020.
## Identity
- **NPI:** 1053930248 (Entity type: Organization)
- **Enumerated:** April 8, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Shine Mmg Inc
- **Organization subpart:** No
- **Authorized official:** Emil Golub, CFO
## Practice location
- **Address:** 450 N BRAND BLVD STE 625A, Glendale, CA 91203-2347
- **Phone:** (818) 745-0070 · **Fax:** (818) 745-0065
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 15 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (10), Emergency Medicine (5); 4 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 8, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1053930248) · Data from the CMS NPPES public registry.