QIAOYUN SHI (MD, PHD) – Child & Adolescent Psychiatry Physician, NPI 1083158075

QIAOYUN SHI (MD, PHD) is a healthcare provider. based in Augusta, Georgia. specializing in PSYCHIATRY. They hold the professional credentials MD, PHD. They hold a License No. 008961 (GA). The NPI Number for QIAOYUN SHI (MD, PHD) is 1083158075

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
QIAOYUN SHI (MD, PHD)
NPI
1083158075
Phone
Not provided
Address
1120 15TH ST
Enumeration Date
9 December 2016
Last Update Date
7 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6264331311
Graduation Year
2001 (25 years ago)
PAC ID
5294153540
Group Practice PAC ID
4082008420
Professional Enrollment ID
I20200917002635
Address ID
CA917312202EL9864XPLXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:9State licenses:2Digital endpointsOther names

832 PSYCHIATRY in GA

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Provider Addresses for QIAOYUN SHI (MD, PHD)

  • Augusta University Medical Center, 1120, 15th Street, Augusta, Richmond County, Georgia, 30912, United States

    AUGUSTA, GA 309120004

    Phone:

    Type: Mailing

  • 9864 BALDWIN PL

    EL MONTE, CA 917312202

    Phone: (626) 433-1311

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-09-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200917002635IPsychiatryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30912)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082008420View full group profile
NameSpecialtyState
P S Y C H I A T R YCA
Marriage And Family TherapistCA
P S Y C H I A T R YCA
Nurse PractitionerCA
P S Y C H I A T R YCA
P S Y C H I A T R YCA
Nurse PractitionerCA
Marriage And Family TherapistCA
P S Y C H I A T R YNY
P S Y C H I A T R YIL

Reviews

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Frequently asked questions

What NPI should I save for QIAOYUN SHI (MD, PHD)?
Save NPI 1083158075 if you need a stable reference for QIAOYUN SHI (MD, PHD).
Is QIAOYUN SHI (MD, PHD) currently active in the NPI registry?
CMS-published data lists QIAOYUN SHI (MD, PHD) as an active registrant.
What kind of provider is QIAOYUN SHI (MD, PHD)?
The page reflects Child & Adolescent Psychiatry Physician for QIAOYUN SHI (MD, PHD). Clinical services aligned with this taxonomy classification.
Where does public data place QIAOYUN SHI (MD, PHD)?
The snapshot lists Augusta, Georgia for QIAOYUN SHI (MD, PHD); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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