Bora Shin, MD is a medicare enrolled "Pediatrics" physician in Buena Park, California. Her current practice location is
7212 Orangethorpe Ave Ste 9a, Buena Park, California. You can reach out to her office (for appointments etc.) via phone at
(714) 503-6550.
Bora Shin is licensed to practice in California (license number A147055) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1912312117.
Physician's Profile
Full Name | Bora Shin |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 7212 Orangethorpe Ave Ste 9a, Buena Park, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1912312117
- Provider Enumeration Date: 06/25/2014
- Last Update Date: 10/07/2021
Medicare PECOS Information:
- PECOS PAC ID: 7416280458
- Enrollment ID: I20190606002115
Medical Identifiers
Medical identifiers for Bora Shin such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1912312117 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 7009 (Georgia) | Secondary |
208000000X | Pediatrics | A147055 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Bora Shin allows following entities to bill medicare on her behalf.
Entity Name | Marque Medical Clinic, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1538466107 PECOS PAC ID: 9537345665 Enrollment ID: O20110525000301 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bora Shin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Bora Shin, MD 1361 Clementine Way, Fullerton, CA 92833-4784 Ph: (817) 789-3549 | Bora Shin, MD 7212 Orangethorpe Ave Ste 9a, Buena Park, CA 90621-4668 Ph: (714) 503-6550 |
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