JIWOONG JOHN SHIN M.D.
NPI 1366804817
Emergency Medicine - Pediatric Emergency Medicine in Hackensack, NJ

Active since March 23, 2016PECOS EnrolledAccepts Medicare Assignment
30 PROSPECT AVE, HACKENSACK, NJ 07601(551) 996-3400 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 31, 2026, May 23, 2019, Mar 23, 2016 (3 updates tracked since 2016).

About Jiwoong John Shin M.d. NPPES

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

JIWOONG JOHN SHIN M.D. (NPI 1366804817) is an individual pediatric emergency medicine provider in Hackensack, New Jersey, licensed in New Jersey (25MA11726700) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1366804817
Entity TypeIndividualMale
Primary Taxonomy207PP0204X
Provider Legal NameJIWOONG JOHN SHINCredential: M.D.
Location Address30 PROSPECT AVEHackensack, NJ 07601-1915
Mailing Address30 Prospect AveHackensack, NJ 07601-1915
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 23, 2016
Last NPPES UpdateMarch 31, 20263 updates tracked since enumeration
NPPES CertifiedMarch 31, 2026
NPI 1366804817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency Medicine · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207PP0204X
License Licensed in NJ · 25MA11726700
Definition

Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.

30 PROSPECT AVE, Hackensack, NJ 07601

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jiwoong John Shin M.d. 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 ID8224372842
PECOS Enrollment IDI20240226000415
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 07601 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366804817, enumerated as an "individual" on March 23, 2016.

The provider is located at 30 PROSPECT AVE HACKENSACK, NJ 07601 and the phone number is (551) 996-3400.

Emergency Medicine with taxonomy code 207PP0204X and a focus in Pediatric Emergency Medicine.