NPIMap

Individual provider Active NPI

Lyudmila Tavrovsky, MD

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1083605687
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
053190 Issued in GA
Practice address
137 Johnson Ferry Rd
Suite 1200
Marietta, GA 30068-4946
Phone
(404) 250-6400
Fax
(404) 250-6405
NPI assigned
Nov 2, 2005
Last updated
Jan 31, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 053190 GA Primary

Addresses

Primary practice location

137 Johnson Ferry Rd
Suite 1200
Marietta, GA 30068-4946

Mailing address

137 Johnson Ferry Rd
Suite 1200
Marietta, GA 30068-4946
Phone (404) 250-6400

Other identifiers 2

IdentifierTypeStateIssuer
838567067BMedicaidGA
838567067AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100721000797 GA Practitioner - Internal Medicine 9739211079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
053190GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients
Emory Specialty Associates, LLC Internal Medicine CurrentSince Jan 1, 2012 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

137 Johnson Ferry Rd
Ste 1200
Marietta, GA 30068
Phone (404) 250-6400

Interoperability endpoints

  • Direct secure messaging: ltavrovsky55673@direct.emory.org

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1083605687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 JOHNSON FERRY RD",
            "address_2": "SUITE 1200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684946",
            "telephone_number": "404-250-6400",
            "fax_number": "404-250-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 JOHNSON FERRY RD",
            "address_2": "SUITE 1200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684946",
            "telephone_number": "404-250-6400",
            "fax_number": "404-250-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVROVSKY",
        "first_name": "LYUDMILA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "053190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "838567067B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "838567067A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.