NPIMap

Individual provider Active NPI

Nino Kvantaliani, MD

  • Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1093292427
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD477262 Issued in PA
Practice address
1815 John F Kennedy Blvd Apt 720
Philadelphia, PA 19103-1705
Phone
(470) 558-8888
NPI assigned
Jul 27, 2018
Last updated
May 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT215375 PA
Neurology Physician 2084N0400X MD477262 PA Primary

Addresses

Primary practice location

1815 John F Kennedy Blvd Apt 720
Philadelphia, PA 19103-1705

Mailing address

1815 John F Kennedy Blvd Apt 720
Philadelphia, PA 19103-1705
Phone (470) 558-8888

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
I20230911003189 GA Practitioner - Neurology 6103280086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2016
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
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

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

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

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
MT215375PAMDInternal Medicine Physician
MD477262PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Aug 1, 2023 Accepting new patients
The Emory Clinic Inc Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Emory Medical Care Foundation Inc Past Accepting new patients
Emory Health Care Neurology Past Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

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

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 6

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 4

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": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1093292427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 JOHN F KENNEDY BLVD APT 720",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031705",
            "telephone_number": "470-558-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 JOHN F KENNEDY BLVD APT 720",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031705",
            "telephone_number": "470-558-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVANTALIANI",
        "first_name": "NINO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT215375",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD477262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.