SOO YEON SHIN
NPI 1205445640
Nurse Practitioner - Family in Cortland, NY

Q: What is Soo Yeon Shin's NPI number?

The NPI number for Soo Yeon Shin is 1205445640. It was assigned to this individual provider in the NPPES registry on July 30, 2020.

Q: What is Soo Yeon Shin's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Soo Yeon Shin was last updated on March 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since July 30, 2020PECOS Enrolled

134 HOMER AVE, CORTLAND, NY 13045(607) 756-3500 Get Directions Write a Review

NPPES record last updated: March 5, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 5, 2021, Feb 25, 2021, Jul 30, 2020 (3 updates tracked since 2020).

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About Soo Yeon Shin NPPES

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

SOO YEON SHIN (NPI 1205445640) is an individual family provider in Cortland, New York, licensed in New York (346297) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205445640

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSOO YEON SHIN

Location Address134 HOMER AVECortland, NY 13045-1206

Mailing Address1 Guthrie SqSayre, PA 18840-1625 · (570) 888-5858

Phone(607) 756-3500

Sole ProprietorNo

Enumeration DateJuly 30, 2020

Last NPPES UpdateMarch 5, 20213 updates tracked since enumeration

NPPES CertifiedMarch 5, 2021

✔ NPI 1205445640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · 346297

134 HOMER AVE, Cortland, NY 13045

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Soo Yeon Shin is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13045 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

DR. NGOZI C MEZU MD

Internal Medicine (Infectious Disease)