Individual provider Active NPI

Tinatin Chabrashvili, M.D.

  • Radiation Oncology Physician
  • Philadelphia, PA
National Provider Identifier
1235316662
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
59408 Issued in MA
Practice address
3401 N Broad St # C525
Philadelphia, PA 19140-5103
Phone
(301) 520-5549
NPI assigned
Jan 28, 2008
Last updated
May 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD435242 PA
Neurology Physician 2084N0400X 000771 GA
Radiation Oncology Physician 2085R0001X 59408 MA Primary

Addresses

Primary practice location

3401 N Broad St # C525
Philadelphia, PA 19140-5103

Mailing address

800 Washington St
Boston, MA 02111-1552
Phone (301) 520-5549

Other identifiers 2

IdentifierTypeStateIssuer
000771OtherGARESIDENCY TRAINING PERMIT
MD435242OtherPAMEDICAL LICENCE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191127002489 NY Practitioner - Neurology 5698835387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurology Medical Service Group LLPGroup PAC ID 7214928035, 39 clinicians

Practice addresses (Care Compare)

90 Presidential PLZ
Suite 4
Syracuse, NY 13202-2240
Phone (315) 464-4243

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.06 of 100Reported as group
Quality
92.53
Promoting interoperability
100
Improvement activities
40
Cost
66.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000771GAMDPsychologist
59408MAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Medical Service Group, LLP Neurology CurrentSince Oct 15, 2019 Accepting new patients
Temple Univ Health System Past Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

90 Presidential Plz
#4
Syracuse, NY 13202
Phone (315) 464-4243

Interoperability endpoints

  • Direct secure messaging: tchabrashvili95290@direct.upstate.edu

Organizations & group practices 3

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 1

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": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1235316662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "301-520-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST # C525",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "301-520-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHABRASHVILI",
        "first_name": "TINATIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD435242",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "000771",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MA",
            "license": "59408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENCY TRAINING PERMIT",
            "identifier": "000771",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE NUMBER",
            "identifier": "MD435242",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.