Gagi Dimitri Otiashvili

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

595769 Issued in NY

Practice address

1708 86TH St Apt 1R
Brooklyn, NY 11214-2800

Phone

(929) 200-3915

NPI assigned

Jan 26, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gagi Eugene Earl Verefkin-Dolgorukov Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1769385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1114876810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 86TH ST APT 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142800",
            "telephone_number": "516-375-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 86TH ST APT 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142800",
            "telephone_number": "929-200-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIASHVILI",
        "first_name": "GAGI",
        "middle_name": "DIMITRI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "595769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KW48674X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAGI EUGENE",
            "last_name": "EARL VEREFKIN-DOLGORUKOV",
            "credential": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yolanda Otero, SLP
• Mael Othelot, CNM
• Othera Occupational Therapy PC
• Ali Mohamed Ali Ahmed Othman, M.D.
• Marlene Marie Othoniel, F.N.P.
• Sarah Otman
• Jessica Otolo
• Enid Naamomo Otoo, DO
• Erica Otoo, LMSW
• Otsar Early Childhood Center

• Registered Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.