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DR. DAVID JAEKWANG SHIM M.D./PH.D.
NPI 1689017451
Internal Medicine - Clinical Cardiac Electrophysiology in Providence, RI

Active since April 11, 2013PECOS EnrolledAccepts Medicare Assignment
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-5891(401) 444-8158 Get Directions Write a Review

NPPES record last updated: October 28, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 16, 2023, Aug 11, 2021, Feb 21, 2019 and 1 more (4 updates tracked since 2017).

About Dr. David Jaekwang Shim M.d./ph.d. NPPES

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

DR. DAVID JAEKWANG SHIM M.D./PH.D. (NPI 1689017451) is an individual clinical cardiac electrophysiology provider in Providence, Rhode Island, licensed in Rhode Island (MD20207) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and is a graduate of Baylor College Of Medicine (2012).

NPPES Registry Identity

NPI1689017451
Entity TypeIndividualMale
Primary Taxonomy207RC0001X
Provider Legal NameDR. DAVID JAEKWANG SHIMCredential: M.D./PH.D.
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 444-5891 · Fax (401) 444-8158
Phone(401) 444-5891
Fax(401) 444-8158
Sole ProprietorNo
Medical School CMSBaylor College Of MedicineGraduated 2012
Enumeration DateApril 11, 2013
Last NPPES UpdateOctober 28, 20244 updates tracked since enumeration
NPPES CertifiedOctober 28, 2024
✔ NPI 1689017451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Clinical Cardiac ElectrophysiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RC0001X
Licenses✔ Licensed in RI · MD20207✔ Licensed in OR · MD208478
Definition
A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
593 EDDY ST, Providence, RI 02903
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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 and accepts Medicare assignment

Dr. David Jaekwang Shim M.d./ph.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 ID8921533407
PECOS Enrollment IDI20241120002709
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 Reassignments

3

Medicare enrollment records show David Shim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifespan Physician Group, Inc.
Same address
General Practice
593 EDDY ST
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 1,372 clinicians in this Medicare group
NPI 1407116643 (401) 444-6779
Rhode Island Hospital
Same address
Advanced Heart Failure and Transplant Cardiology
593 EDDY ST, GEORGE BLDG., 1ST FLOOR
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 67 clinicians in this Medicare group
NPI 1962844795 (401) 606-1004
The Miriam Hospital
3.1 mi
Cardiovascular Disease
208 COLLYER ST, SUITE 100
Providence, RI 02904
  • Reassigned Medicare billing, Rhode Island enrollment
  • 106 clinicians in this Medicare group
NPI 1851677470 (401) 793-7191

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

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Rhode Island Hospital

Acute Care Hospitals · Providence, RI
3/5 CMS rating
OwnershipTribal
CMS Certification Number410007
Location593 Eddy StreetProvidence, RI 02903 · Providence County
Emergency services

The Miriam Hospital

Acute Care Hospitals · Providence, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410012
Location164 Summit AvenueProvidence, RI 02906 · Providence County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02903 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
$134.17 typical visit price
range $58.57 – $177.03
Typical copayment $33.54 (range $14.64 – $44.25)
Most-billed visit code 99204
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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.

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 David Shim's NPI number?

The NPI number for David Shim is 1689017451. It was assigned to this individual provider in the NPPES registry on April 11, 2013.

Where is David Shim located?

David Shim practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-5891.

What is David Shim's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Clinical Cardiac Electrophysiology, with taxonomy code 207RC0001X.

Is David Shim enrolled in Medicare?

Yes. David Shim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for David Shim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Shim reassigns Medicare benefits to 3 organizations: Lifespan Physician Group, Inc. (Providence, RI), Rhode Island Hospital (Providence, RI) and The Miriam Hospital (Providence, RI). Each 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 David Shim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is David Shim affiliated with any hospitals?

According to CMS data, David Shim is affiliated with Rhode Island Hospital and The Miriam Hospital.

When was this NPI record last updated?

The NPPES record for David Shim was last updated on October 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.