Individual provider Active NPI

Tamar Tamarashvili, MD

  • Family Medicine Physician
  • Crescent City, CA
National Provider Identifier
1013698919
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A207399 Issued in CA
Practice address
780 E Washington Blvd
Crescent City, CA 95531-8397
Phone
(707) 464-6715
NPI assigned
Jul 25, 2023
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A207399 CA Primary

Addresses

Primary practice location

780 E Washington Blvd
Crescent City, CA 95531-8397

Mailing address

5051 Lake Earl Dr
Crescent City, CA 95531-9738
Phone (707) 464-6715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822004156 LA Order and Referring Only - Family PracticePractitioner - Family Practice 2860855988

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Sacramento, CA 95827

PO Box
Suite 255228
Sacramento, CA 95865-5228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1013698919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 LAKE EARL DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955319738",
            "telephone_number": "707-464-6715",
            "fax_number": "707-465-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 E WASHINGTON BLVD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318397",
            "telephone_number": "707-464-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMARASHVILI",
        "first_name": "TAMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A207399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.