1. Home
  2. Directory
  3. California
  4. Pasadena
  5. Family Medicine
  6. NPI Profile

KIMBERLEY I SHINE M D INC
NPI 1376997221
Family Medicine in Pasadena, CA

Active since April 18, 2016
960 E GREEN ST STE 206, PASADENA, CA 91106(626) 222-8636(626) 317-0192 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kimberley I Shine M D Inc NPPES

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

KIMBERLEY I SHINE M D INC (NPI 1376997221) is a healthcare organization registered as a family medicine in Pasadena, California and active in the NPI registry since April 2016. The organization lists Kimberley I Shine, Owner, as its authorized official.

NPPES Registry Identity

NPI1376997221
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKIMBERLEY I SHINE M D INC
Location Address960 E GREEN ST STE 206Pasadena, CA 91106-2401
Mailing Address960 E Green St Ste 206Pasadena, CA 91106-2401 · (626) 222-8636 · Fax (626) 317-0192
Phone(626) 222-8636
Fax(626) 317-0192
Organization SubpartNo
Authorized OfficialKimberley I ShineOwner · (626) 222-8636
Enumeration DateApril 18, 2016
Last NPPES UpdateJuly 15, 2024
NPPES CertifiedJuly 15, 2024
✔ NPI 1376997221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A76961
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
960 E GREEN ST STE 206, Pasadena, CA 91106
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberley I Shine M D Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kimberley I Shine M D Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kimberley Shine, MD
Family Practice
NPI 1598724114
960 E GREEN ST STE 206
Pasadena, CA 91106
(626) 307-0207
✔ PECOS✔ Accepts MedicareSame address

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 Kimberley I Shine M D Inc's NPI number?

The NPI number for Kimberley I Shine M D Inc is 1376997221. It was assigned to this organization in the NPPES registry on April 18, 2016.

Where is Kimberley I Shine M D Inc located?

Kimberley I Shine M D Inc is located at 960 E Green St Ste 206, Pasadena, CA 91106. The listed phone number is (626) 222-8636.

What is Kimberley I Shine M D Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kimberley I Shine M D Inc enrolled in Medicare?

Yes. Kimberley I Shine M D Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kimberley I Shine M D Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Kimberley I Shine M D 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kimberley I Shine M D Inc was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.