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EITHAR ELIAS SHABBO
NPI 1285437491
Internal Medicine in Fort Wayne, IN

Active since March 31, 2025PECOS Enrolled
2200 RANDALLIA DR, FORT WAYNE, IN 46805(260) 373-7765 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 4, 2025, Mar 31, 2025 (2 updates tracked since 2025).

About Eithar Elias Shabbo NPPES

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

EITHAR ELIAS SHABBO (NPI 1285437491) is an individual internal medicine provider in Fort Wayne, Indiana, licensed in Indiana (11024165A) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285437491
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameEITHAR ELIAS SHABBO
Location Address2200 RANDALLIA DRFort Wayne, IN 46805-4638
Mailing Address2200 Randallia DrFort Wayne, IN 46805-4638 · (260) 373-7765
Phone(260) 373-7765
Sole ProprietorNo
Enumeration DateMarch 31, 2025
Last NPPES UpdateJuly 4, 20252 updates tracked since enumeration
NPPES CertifiedJuly 4, 2025
✔ NPI 1285437491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IN · 11024165A
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2200 RANDALLIA DR, Fort Wayne, IN 46805
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eithar Elias Shabbo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 46805 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
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 20

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

MALLIKA GYAWALI MD
Internal Medicine
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
CHRISTINA MCGUIRK
Emergency Medicine
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
MS. KARI M RASMUSSEN PA-C
Physician Assistant (Medical)
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
MR. THOMAS G EDWARDS PA-C
Physician Assistant (Medical)
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.
Pediatrics (Neonatal-Perinatal Medicine)
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (800) 727-8439
JACQUOLYNN LEE PLOUGHE BSN, RN, CRRN
Registered Nurse
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 266-4172
DAVID R WANG DO, MPH
Student in an Organized Health Care Education/Training Program
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-7765
CHELSIE MCSORLEY NP
Nurse Practitioner
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-0670

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 Eithar Shabbo's NPI number?

The NPI number for Eithar Shabbo is 1285437491. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Where is Eithar Shabbo located?

Eithar Shabbo practices at 2200 Randallia Dr, Fort Wayne, IN 46805. The listed phone number is (260) 373-7765.

What is Eithar Shabbo's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Eithar Shabbo enrolled in Medicare?

Yes. Eithar Shabbo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Eithar Shabbo was last updated on July 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.