SHRIYANI TAYLOR TYSEN NP
NPI 1184462061
Nurse Practitioner - Pediatrics in South Bend, IN

Active since July 16, 2024PECOS Enrolled
621 MEMORIAL DR STE 612, SOUTH BEND, IN 46601(574) 232-3325 Get Directions Write a Review

NPPES record last updated: December 19, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 19, 2025, Jul 1, 2025, Jul 16, 2024 (3 updates tracked since 2024).

About Shriyani Taylor Tysen Np NPPES

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

SHRIYANI TAYLOR TYSEN NP (NPI 1184462061) is an individual pediatrics provider in South Bend, Indiana, licensed in Indiana (71015594A) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1184462061
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameSHRIYANI TAYLOR TYSENCredential: NP
Location Address621 MEMORIAL DR STE 612South Bend, IN 46601-1085
Mailing AddressPo Box 778912Chicago, IL 60677-8912 · (317) 777-6435 · Fax (317) 777-6644
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 16, 2024
Last NPPES UpdateDecember 19, 20253 updates tracked since enumeration
NPPES CertifiedDecember 19, 2025
NPI 1184462061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License Licensed in IN · 71015594A
621 MEMORIAL DR STE 612, South Bend, IN 46601

Other Identifiers 1

Medicaid300110761IN

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Shriyani Taylor Tysen Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9931694205
PECOS Enrollment IDI20251223004376
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics (Pediatric Cardiology)
621 MEMORIAL DR STE 612
SOUTH BEND, IN 46601

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 Shriyani Tysen's NPI number?

The NPI number for Shriyani Tysen is 1184462061. It was assigned to this individual provider in the NPPES registry on July 16, 2024.

Where is Shriyani Tysen located?

Shriyani Tysen practices at 621 Memorial Dr Ste 612, South Bend, IN 46601. The listed phone number is (574) 232-3325.

What is Shriyani Tysen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Shriyani Tysen enrolled in Medicare?

Yes. Shriyani Tysen is registered in the Medicare PECOS enrollment system.

What insurance does Shriyani Tysen accept?

Health plans from CareSource list Shriyani Tysen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shriyani Tysen was last updated on December 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.