Mindia Gabichvadze, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY34139 Issued in CA

Practice address

9713 Santa Monica Blvd Ste 201
Beverly Hills, CA 90210-4236

Phone

(310) 564-5400

Fax

(844) 654-2900

NPI assigned

Oct 7, 2009

Last updated

Jul 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medens HealthGroup PAC ID 4880014877, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medens Health

  • Clinical Psychologist
  • San Francisco, CA
  • NPI 1003431784

  Clinical Neuropsychologist

  Medicare reassignment Care Compare group NPD
• Silver Owl Connections, LLC

  • Psychologist
  • Pasadena, CA
  • NPI 1548670797
  NPD

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1063747137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9713 SANTA MONICA BLVD STE 201",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104236",
            "telephone_number": "310-564-5400",
            "fax_number": "844-654-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9713 SANTA MONICA BLVD STE 201",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104236",
            "telephone_number": "310-564-5400",
            "fax_number": "844-654-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABICHVADZE",
        "first_name": "MINDIA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY34139",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julian Eliahu Gabbay, DDS
• Niloufar Gabbay, PA-C
• Shahla M Gabbay, MFT
• Gabriel Gabbaypour, DDS MD
• Tzur S Gabi, D.M.D
• Gabriel Gabbaypour, DDS, MD, Inc
• Gabriel Rubanenko, M.D. Inc
• Gabrielle B Davis MD, Inc (Gabrielle B. Davis, MD Plastic Surgery)
• Ron Gad, MA, MFT
• Michelle Gagnon

• Clinical Neuropsychologist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.