Shayan Khorsandi, MD is a medicare enrolled "Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery" physician in Vega Baja, Puerto Rico. His current practice location is
Carretera #2, Kilometer 39.5, Ofic. 110, Vega Baja, Puerto Rico. You can reach out to his office (for appointments etc.) via phone at
(787) 226-5425.
Shayan Khorsandi is licensed to practice in Puerto Rico (license number 021715) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083159305.
Physician's Profile
| Full Name | Shayan Khorsandi |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery |
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| Location | Carretera #2, Kilometer 39.5, Vega Baja, Puerto Rico |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1083159305
- Provider Enumeration Date: 12/21/2016
- Last Update Date: 11/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 1254682354
- Enrollment ID: I20201228002387
Medical Identifiers
Medical identifiers for Shayan Khorsandi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083159305 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 25MA10177800 (New Jersey) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 207VF0040X | Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery | 021715 (Puerto Rico) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shayan Khorsandi allows following entities to bill medicare on his behalf.
| Entity Name | Obhg California Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215258892
PECOS PAC ID: 8729276795
Enrollment ID: O20101217000826 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shayan Khorsandi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shayan Khorsandi, MD
16 Plaza Santa Cruz,
Trujillo Alto, PR 00976-6123
Ph: (787) 226-5425 | Shayan Khorsandi, MD
Carretera #2, Kilometer 39.5, Ofic. 110,
Vega Baja, PR 00693
Ph: (787) 226-5425 |
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