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EDWARD DONG-HO SHIN
NPI 1912656752
Student in an Organized Health Care Education/Training Program in Oakland, CA

Active since March 21, 2022PECOS EnrolledAccepts Medicare Assignment
275 W MACARTHUR BLVD, OAKLAND, CA 94611(510) 752-1000 Get Directions Write a Review

NPPES record last updated: March 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Edward Dong-ho Shin NPPES

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

EDWARD DONG-HO SHIN (NPI 1912656752) is an individual student in an organized health care education/training program in Oakland, California and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of University Of Wisconsin School Of Medicine (2018).

NPPES Registry Identity

NPI1912656752
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameEDWARD DONG-HO SHIN
Location Address275 W MACARTHUR BLVDOakland, CA 94611-5641
Mailing Address275 W Macarthur BlvdOakland, CA 94611-5641
Phone(510) 752-1000
Sole ProprietorYes
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2018
Enumeration DateMarch 21, 2022
NPPES CertifiedMarch 21, 2022
✔ NPI 1912656752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
275 W MACARTHUR BLVD, Oakland, CA 94611
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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

Edward Dong-ho Shin 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 ID9739628512
PECOS Enrollment IDI20240823003319
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 Edward Shin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
10 mi
Internal Medicine
901 NEVIN
Richmond, CA 94801
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1235226531 (510) 307-1555

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

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. ANNA C. MORGAN MD
Specialist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. TRANG H. LA MD
Radiology (Radiation Oncology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. AMIN MATIN M.D., M.P.H.
Radiology (Diagnostic Radiology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (925) 295-5758
SUCHETA KORWAR MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
MR. MATTHEW GABRIELSON D.P.T.
Physical Therapist (Orthopedic)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6221
MALORIE HACKER MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
RENEE L. PERRY DO
Obstetrics & Gynecology
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
HERPRIT KAUR MAHAL MD
Hospitalist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000

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 Edward Shin's NPI number?

The NPI number for Edward Shin is 1912656752. It was assigned to this individual provider in the NPPES registry on March 21, 2022.

Where is Edward Shin located?

Edward Shin practices at 275 W Macarthur Blvd, Oakland, CA 94611. The listed phone number is (510) 752-1000.

What is Edward Shin's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Edward Shin enrolled in Medicare?

Yes. Edward Shin 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 organization bills Medicare for Edward Shin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edward Shin reassigns Medicare benefits to Permanente Medical Group Inc (Richmond, 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 Edward 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 Edward Shin was last updated on March 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.