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DR. IDEAN POURSHAMS MD
NPI 1952006843
Student in an Organized Health Care Education/Training Program in Fayetteville, AR

Active since March 31, 2023PECOS Enrolled
1125 N COLLEGE AVE # SLOT100, FAYETTEVILLE, AR 72703(479) 713-8310 Get Directions Write a Review

NPPES record last updated: March 31, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Idean Pourshams Md NPPES

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

DR. IDEAN POURSHAMS MD (NPI 1952006843) is an individual student in an organized health care education/training program in Fayetteville, Arkansas and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952006843
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. IDEAN POURSHAMSCredential: MD
Location Address1125 N COLLEGE AVE # SLOT100Fayetteville, AR 72703-1908
Mailing Address1125 N College Ave # Slot100Fayetteville, AR 72703-1908
Phone(479) 713-8310
Sole ProprietorYes
Enumeration DateMarch 31, 2023
NPPES CertifiedMarch 31, 2023
✔ NPI 1952006843 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.
1125 N COLLEGE AVE # SLOT100, Fayetteville, AR 72703
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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)

Dr. Idean Pourshams Md 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.

OLUWASEUN ABAYOMI OGUNTUASE MD
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8310
SASIN PAYAKACHAT MD
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8310
JENNIFER SARAH GEORGE DO
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8310
CHINEMEREM MARTLIN EMEASOBA MBBS
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8310
LEAH PITTMAN MD
Internal Medicine
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8310
MOHAMMAD ABEEL TARIQ MD, MBBS
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8310
JORDAN ILAH POWERS MD
Internal Medicine
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8310
MAMUA MARY ANDELA MD
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703
Washington County (479) 713-8700

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 Idean Pourshams's NPI number?

The NPI number for Idean Pourshams is 1952006843. It was assigned to this individual provider in the NPPES registry on March 31, 2023.

Where is Idean Pourshams located?

Idean Pourshams practices at 1125 N College Ave # Slot100, Fayetteville, AR 72703. The listed phone number is (479) 713-8310.

What is Idean Pourshams's specialty?

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

Is Idean Pourshams enrolled in Medicare?

Yes. Idean Pourshams is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Idean Pourshams was last updated on March 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.