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SUNG JAE SHIN LCSW
NPI 1710575568
Social Worker - Clinical in Rego Park, NY

Active since January 07, 2021PECOS Enrolled
6110 ALDERTON ST APT B3, REGO PARK, NY 11374(929) 206-7720 Get Directions Write a Review

NPPES record last updated: June 7, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 7, 2024, Aug 10, 2021, Jan 7, 2021 (3 updates tracked since 2021).

About Sung Jae Shin Lcsw NPPES

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

SUNG JAE SHIN LCSW (NPI 1710575568) is an individual clinical provider in Rego Park, New York, licensed in New York (097784) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1710575568
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameSUNG JAE SHINCredential: LCSW
Location Address6110 ALDERTON ST APT B3Rego Park, NY 11374-2702
Mailing Address7119 165th StFresh Meadows, NY 11365-4225 · (929) 206-7720
Phone(929) 206-7720
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJanuary 7, 2021
Last NPPES UpdateJune 7, 20243 updates tracked since enumeration
NPPES CertifiedJune 7, 2024
✔ NPI 1710575568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 097784
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 091861 (NY)
6110 ALDERTON ST APT B3, Rego Park, NY 11374
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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 (PECOS)

Sung Jae Shin Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840735965
PECOS Enrollment IDI20260506000844
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

4

Medicare enrollment records show Sung Jae Shin reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bleuler Psychotherapy Center, Inc.
1.2 mi
Mental Health (Including Community Mental Health Center)
104-70 QUEENS BOULEVARD, SUITE 200
Forest Hills, NY 11375
  • Reassigned Medicare billing, New York enrollment
  • 74 clinicians in this Medicare group
NPI 1801949706 (718) 275-6010
Valera Medical, P.C.
4.8 mi
Psychiatry
134 N 4TH ST
Brooklyn, NY 11249
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Valera Medical PC
  • 315 clinicians in this Medicare group
NPI 1437782349 (646) 450-7748
Grow Healthcare Group Of New Jersey PC
8.3 mi
Mental Health
221 RIVER ST. FL 9
Hoboken, NJ 07030
  • Reassigned Medicare billing, New Jersey enrollment
  • 673 clinicians in this Medicare group
NPI 1841949328 (201) 439-8902
Grow Healthcare Group PA
1,093 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, New York enrollment
  • 867 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

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 11374 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
$0.00 typical visit price
range $67.00 – $201.98
Typical copayment $0.00 (range $16.75 – $50.49)
Most-billed visit code NA
Established Patient
$82.96 typical visit price
range $21.62 – $163.52
Typical copayment $20.74 (range $5.40 – $40.88)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Sung Jae Shin's NPI number?

The NPI number for Sung Jae Shin is 1710575568. It was assigned to this individual provider in the NPPES registry on January 7, 2021.

Where is Sung Jae Shin located?

Sung Jae Shin practices at 6110 Alderton St Apt B3, Rego Park, NY 11374. The listed phone number is (929) 206-7720.

What is Sung Jae Shin's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Sung Jae Shin enrolled in Medicare?

Yes. Sung Jae Shin is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sung Jae Shin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sung Jae Shin reassigns Medicare benefits to 4 organizations: Bleuler Psychotherapy Center, Inc. (Forest Hills, NY), Valera Medical, P.C. (Brooklyn, NY), Grow Healthcare Group Of New Jersey PC (Hoboken, NJ) and Grow Healthcare Group PA (Miami, FL). 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 Sung Jae 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 Sung Jae Shin was last updated on June 7, 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.