Otar Datiashvili, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01093706A Issued in IN

Practice address

2651 E Discovery Pkwy
Bloomington, IN 47408-9059

Phone

(812) 353-9515

Fax

(812) 353-9275

NPI assigned

Jun 22, 2015

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS, PA, NY, IN, TN5 enrollments

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 5

Specialty

Emergency Medicine

Education

State University of New York at Stony Brook, School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist South Emergency Physicians, PLLCGroup PAC ID 6406205608, 48 clinicians

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Olive Branch Emergency Physicians LLCGroup PAC ID 9335598739, 27 clinicians

Concord Company of Tennessee PLLCGroup PAC ID 0345588109, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Paoli Hospital Hospital, Paoli, IN, CCN 151306
• Perry County Memorial Hospital Hospital, Tell City, IN, CCN 151322
• Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Merit-based Incentive Payment System (MIPS)

Final score

92.62 of 100Reported as apm

Quality

77.97

Promoting interoperability

98

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

91.85 of 100Reported as group

Quality

79.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 33)

Interoperability endpoints

• Direct secure messaging: otar.datiashvili.p1@direct.shproviders.nextgenshare.com
• Direct secure messaging: odatiashvili@direct.iuhealth.org

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.

• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Concord Company of Tennessee PLLC

  • Emergency Medicine Physician
  • Leitchfield, KY
  • NPI 1649743667

  IN

  Medicare reassignment Care Compare group NPD
• Methodist South Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1609657873
  Medicare reassignment Care Compare group NPD
• Olive Branch Emergency Physicians LLC

  • Emergency Medicine Physician
  • Olive Branch, MS
  • NPI 1730969734
  Medicare reassignment Care Compare group NPD
• Emergency Professionals of Indiana, P.C.

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1013951219
  Medicare reassignment NPD
• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment NPD
• Germantown Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Germantown, TN
  • NPI 1518747526
  Medicare reassignment NPD
• Mary Imogene Bassett Hospital

  • Multi-Specialty Clinic/Center
  • Cooperstown, NY
  • NPI 1083664221
  Medicare reassignment NPD
• Meeting House Lane Medical Practice PC

  • Internal Medicine Physician
  • Southampton, NY
  • NPI 1902088495
  Medicare reassignment NPD
• Methodist North Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1801677083
  Medicare reassignment NPD
• Methodist University Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1023899291
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Bloomington Inc

  • General Acute Care Hospital
  • Bloomington, IN
  • NPI 1205860335
  Care Compare affiliation
• Indiana University Health Paoli Inc

  • Critical Access Hospital
  • Paoli, IN
  • NPI 1912984451
  Care Compare affiliation
• Perry County Memorial Hospital

  • Ambulance
  • Tell City, IN
  • NPI 1356309777

  Hospital

  Care Compare affiliation
• Perry County Memorial Hospital

  • Critical Access Hospital
  • Tell City, IN
  • NPI 1699779017
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation
• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1083096572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 E DISCOVERY PKWY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089059",
            "telephone_number": "812-353-9515",
            "fax_number": "812-353-9275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Roberts Dr Ste 313",
            "address_purpose": "LOCATION",
            "city": "North Adams",
            "state": "MA",
            "postal_code": "012473254",
            "country_code": "US",
            "telephone_number": "413-398-5509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATIASHVILI",
        "first_name": "OTAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01093706A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "273598-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03782025",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "odatiashvili@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon S Dantonio, NP
• Robarn Danzman, LPC
• Sydney Dapuzzo
• Claire Darnell
• James Aaron Dash
• Cassidy Daugherty, RBT
• Liana Daugherty
• Olivia Daugherty, RBT
• Dauntless Counseling and Consulting LLC
• Abigail Davenport-Mikusak, RBT

• Emergency Medicine Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.