Shirnett Khorran-Gajaraj

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2349747 Issued in MA

Practice address

529 Pearl St
Brockton, MA 02301-2825

Phone

(508) 580-2211

NPI assigned

Mar 26, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

CK Wellness PLLCGroup PAC ID 8628579000, 2 clinicians

Starr Psychiatric Center IncGroup PAC ID 4385742626, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CK Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brockton, MA
  • NPI 1679363097
  Medicare reassignment Care Compare group NPD
• Starr Psychiatric Center Inc

  • Psychiatry Physician
  • Brockton, MA
  • NPI 1871687129
  Medicare reassignment Care Compare group NPD
• Arbour Inc

  • Psychiatry Physician
  • Boston, MA
  • NPI 1770766529
  Medicare reassignment NPD
• Arbour Inc

  dba Arbour Hospital

  • Psychiatric Hospital
  • Boston, MA
  • NPI 1821068818
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1538919147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012825",
            "telephone_number": "508-580-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHORRAN-GAJARAJ",
        "first_name": "SHIRNETT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2349747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amirah Nabiyah Khan, M.D.
• Humayon B Khan, M.D
• Ilea Alexis Khan, M.D.
• Natasha Bita Khazai, MD
• Muhammad Omer Khokhar, M.D.
• Simon Kidanemariam, MD
• Claudia Isaac Kidd
• Stephanie Kierstead
• Kyle Kiessling, BS PSYCHOLOGY
• Raphael I. Kieval, MD

• Psychiatric/Mental Health Nurse Practitioner in Brockton, MA
• Providers in Brockton, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.