SHRIYANI TAYLOR TYSEN NP
NPI 1184462061
Nurse Practitioner - Pediatrics in South Bend, IN
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
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shriyani Taylor Tysen Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shriyani Tysen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Indianapolis, IN 46202
- Reassigned Medicare billing, Indiana enrollment
- 5,212 clinicians in this Medicare group
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 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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organization bills Medicare for Shriyani Tysen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shriyani Tysen reassigns Medicare benefits to Iu Health Medical Group, LLC (Indianapolis, IN). 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 Shriyani Tysen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shriyani Tysen accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer 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 10 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.
# Shriyani Taylor Tysen, NP · NPI 1184462061
Pediatrics physician in South Bend, Indiana. Individual provider, active in the CMS NPPES registry since July 16, 2024.
## Identity
- **NPI:** 1184462061 (Entity type: Individual)
- **Enumerated:** July 16, 2024
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 71015594A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 621 MEMORIAL DR STE 612, South Bend, IN 46601-1085
- **Phone:** (574) 232-3325
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Iu Health Medical Group, LLC (NPI 1326893777, Indianapolis, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** December 19, 2025
- **Other identifiers:** Medicaid 300110761 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1184462061) · Data from the CMS NPPES public registry.