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SHAYAN KHURRAM DO
NPI 1356130801
Student in an Organized Health Care Education/Training Program in Fort Wayne, IN

Active since May 01, 2025PECOS Enrolled
2200 RANDALLIA DR, FORT WAYNE, IN 46805(260) 373-7765 Get Directions Write a Review

NPPES record last updated: May 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shayan Khurram Do NPPES

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

SHAYAN KHURRAM DO (NPI 1356130801) is an individual student in an organized health care education/training program in Fort Wayne, Indiana and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356130801
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHAYAN KHURRAMCredential: DO
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 DateMay 1, 2025
NPPES CertifiedMay 1, 2025
✔ NPI 1356130801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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)

Shayan Khurram Do 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.

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 Shayan Khurram's NPI number?

The NPI number for Shayan Khurram is 1356130801. It was assigned to this individual provider in the NPPES registry on May 1, 2025.

Where is Shayan Khurram located?

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

What is Shayan Khurram's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shayan Khurram enrolled in Medicare?

Yes. Shayan Khurram is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shayan Khurram was last updated on May 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.