Mariam Tsikvadze, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD218074 Issued in OR

Practice address

3377 Riverbend Dr
Springfield, OR 97477-8803

Phone

(541) 222-8400

Fax

(541) 222-8401

NPI assigned

Jun 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, OR2 enrollments

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 2

Specialty

Neurology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
• Peace Harbor Medical Center Hospital, Florence, OR, CCN 381316
• Curry General Hospital Hospital, Gold Beach, OR, CCN 381322

Merit-based Incentive Payment System (MIPS)

Final score

93.86 of 100Reported as group

Quality

95

Promoting interoperability

100

Improvement activities

40

Cost

80.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtsikvadze1753597@ehrdirect.mayoclinicmsg.org
• Direct secure messaging: mtsikvadze658474@direct.peacehealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peacehealth

  • Hospitalist Physician
  • Springfield, OR
  • NPI 1740223874
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Jacksonville

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1790772317
  Medicare reassignment NPD
• Mayo Clinic Jacksonville

  • Home Infusion Therapy Pharmacy
  • Jacksonville, FL
  • NPI 1003510116
  NPD
• Mayo Clinic Jacksonville

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1871054106
  NPD

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

• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Curry Health District

  • Critical Access Hospital Clinic/Center
  • Brookings, OR
  • NPI 1083656367
  Care Compare affiliation
• Curry Health District

  • Critical Access Hospital
  • Gold Beach, OR
  • NPI 1487696985
  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  Care Compare affiliation
• Peacehealth

  • Psychiatric Hospital Unit
  • Eugene, OR
  • NPI 1568236974
  Care Compare affiliation
• Peacehealth

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  Care Compare affiliation

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1326533316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-8400",
            "fax_number": "541-222-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 San Pablo Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322241865",
            "country_code": "US",
            "telephone_number": "904-953-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Ave MC 1921",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060301921",
            "country_code": "US",
            "telephone_number": "860-679-2147",
            "fax_number": "860-679-4624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSIKVADZE",
        "first_name": "MARIAM",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD218074",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME154920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtsikvadze1753597@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Tundra BH Oregon LLC

• Neurology Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• Neurology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.