SUNG SHIM PA-C
NPI 1407551674
Physician Assistant - Surgical in Stamford, CT

Q: What is Sung Shim's NPI number?

The NPI number for Sung Shim is 1407551674. It was assigned to this individual provider in the NPPES registry on April 4, 2023.

Q: What is Sung Shim's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Sung Shim was last updated on June 26, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 04, 2023PECOS EnrolledAccepts Medicare Assignment

1 HOSPITAL PLZ, STAMFORD, CT 06902(203) 278-7022 Get Directions Write a Review

NPPES record last updated: June 26, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Sung Shim Pa-c NPPES

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

SUNG SHIM PA-C (NPI 1407551674) is an individual surgical provider in Stamford, Connecticut, licensed in Connecticut (5996) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Stamford, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1407551674

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameSUNG SHIMCredential: PA-C

Location Address1 HOSPITAL PLZStamford, CT 06902-3602

Mailing Address1 Hospital PlazaStamford, CT 06902 · (203) 278-7022

Phone(203) 278-7022

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 4, 2023

Last NPPES UpdateJune 26, 2023

NPPES CertifiedJune 26, 2023

✔ NPI 1407551674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in CT · 5996

1 HOSPITAL PLZ, Stamford, CT 06902

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Secondary Practice Location 1

Location 132 Strawberry Hill CourtStamford, CT 06902-3602 · Phone (203) 278-7022 · Fax (203) 276-5560

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

Sung Shim Pa-c 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 ID2567829468

PECOS Enrollment IDI20230608001265

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.

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.

MRS. SNJEZANA MORAN PA-C

Physician Assistant (Surgical)