JAE Y. SHIM MD
NPI 1366519274
Pediatrics in Fontana, CA

Q: What is Jae Shim's NPI number?

The NPI number for Jae Shim is 1366519274. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Q: What is Jae Shim's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jae Shim was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 November 29, 2006PECOS Enrolled

9961 SIERRA AVE, FONTANA, CA 92335(909) 427-3910 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Jae Y. Shim Md NPPES

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

JAE Y. SHIM MD (NPI 1366519274) is an individual pediatrics provider in Fontana, California, licensed in California (A54004) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366519274

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameJAE Y. SHIMCredential: MD

Location Address9961 SIERRA AVEFontana, CA 92335-6720

Mailing Address9961 Sierra AveFontana, CA 92335-6720 · (909) 427-3910

Phone(909) 427-3910

Sole ProprietorNo

Enumeration DateNovember 29, 2006

Last NPPES UpdateDecember 3, 2021

✔ NPI 1366519274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · A54004

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

9961 SIERRA AVE, Fontana, CA 92335

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jae Y. Shim Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Jae Shim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group

Same address

Health Maintenance Organization

9961 SIERRA AVE
Fontana, CA 92335

Reassigned Medicare billing, California enrollment
5,228 clinicians in this Medicare group

NPI 1689606196 (909) 427-3910

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92335 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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.

SHEILA ANN VANALLEN PT

Physical Therapist

9961 SIERRA AVE, BUILDING 3A
FONTANA, CA 92335

San Bernardino County (909) 427-7727

MR. JAMES DAVID KILLEEN III M.D.

Pediatrics

9961 SIERRA AVE, KAISER PERMANENTE FONTANA - PEDIATRICS
FONTANA, CA 92335

San Bernardino County (909) 427-6960

MR. DHIRESH N PATEL RPH

Pharmacist