1. Home
  2. Directory
  3. California
  4. Orange
  5. Pediatrics
  6. NPI Profile

SUSIE SHIN MD
NPI 1407505167
Pediatrics in Orange, CA

Active since March 21, 2022PECOS Enrolled
505 S MAIN ST STE 525, ORANGE, CA 92868(714) 456-5631 Get Directions Write a Review

NPPES record last updated: July 21, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Susie Shin Md NPPES

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

SUSIE SHIN MD (NPI 1407505167) is an individual pediatrics provider in Orange, California, licensed in California (A188250) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Irvine, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2022).

NPPES Registry Identity

NPI1407505167
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameSUSIE SHINCredential: MD
Location Address505 S MAIN ST STE 525Orange, CA 92868-4553
Mailing Address505 S Main St Ste 525Orange, CA 92868-4553 · (714) 456-5631
Phone(714) 456-5631
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2022
Enumeration DateMarch 21, 2022
Last NPPES UpdateJuly 21, 2025
NPPES CertifiedJuly 21, 2025
✔ NPI 1407505167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A188250
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.
505 S MAIN ST STE 525, Orange, CA 92868
Open in Google Maps ↗

Secondary Practice Location 1

Location 14968 Booth Cir Ste 106Irvine, CA 92604-3370 · Phone (949) 387-4900 · Fax (949) 387-4900

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID6002266905
PECOS Enrollment IDI20251030002197
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 Susie Shin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
5.8 mi
Health Maintenance Organization
441 N LAKEVIEW AVE
Anaheim, CA 92807
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1952333460 (714) 279-4000

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 92868 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

LINDSEY LILL
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
ESTHER CHANG
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (925) 785-6878
LUKE YU MD
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 456-5631
CHARISSA LAU
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
MARIA NGUYEN DO
Pediatrics
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
REGINA TANG
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
DEAN TODD MD
Pediatrics
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 456-5631
KATHERINE ALOYSIUS KILLMOND
Pediatrics
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 456-5631

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 Susie Shin's NPI number?

The NPI number for Susie Shin is 1407505167. It was assigned to this individual provider in the NPPES registry on March 21, 2022.

Where is Susie Shin located?

Susie Shin practices at 505 S Main St Ste 525, Orange, CA 92868. The listed phone number is (714) 456-5631.

What is Susie Shin's specialty?

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

Is Susie Shin enrolled in Medicare?

Yes. Susie Shin is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Susie Shin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susie Shin reassigns Medicare benefits to Southern California Permanente Medical Group (Anaheim, CA). The 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 Susie Shin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Susie Shin was last updated on July 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.