Organization Active NPI

Lusomed LLC

  • Medical Specialty Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1104778638
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
LUSOMED LLC
Practice address
2635 E 24TH St Apt 1
Brooklyn, NY 11235-2698
Phone
(347) 733-3709
NPI assigned
Feb 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Authorized official

Name
Ketevani Shavliashvili, NON-US MD DEGREE
Title
Founder & Ceo
Phone
(347) 733-3709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

2635 E 24TH St Apt 1
Brooklyn, NY 11235-2698

Mailing address

2635 E 24TH St Apt 1
Brooklyn, NY 11235-2698

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1770595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1104778638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 E 24TH ST APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 E 24TH ST APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352698",
            "telephone_number": "347-733-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUSOMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-09",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A",
        "authorized_official_last_name": "SHAVLIASHVILI",
        "authorized_official_first_name": "KETEVANI",
        "authorized_official_title_or_position": "FOUNDER & CEO",
        "authorized_official_telephone_number": "347-733-3709",
        "authorized_official_credential": "NON-US MD DEGREE"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.