Individual provider Active NPI

Nino O Kurtsikidze, M.D.

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1376516724
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME100749 Issued in FL
Practice address
1839 Central Ave
St Petersburg, FL 33713-8900
Phone
(727) 322-1054
Fax
(727) 822-8081
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME100749 FL Primary

Addresses

Primary practice location

1839 Central Ave
St Petersburg, FL 33713-8900

Mailing address

1839 Central Ave
St Petersburg, FL 33713-8900
Phone (727) 322-1054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20081212000358 FL Practitioner - Internal Medicine 9436227287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Health Care of Pinellas, LLCGroup PAC ID 1658274675, 88 clinicians

Practice addresses (Care Compare)

1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas Inc. CurrentSince Aug 1, 2008 Accepting new patients
MG H2 LLC CurrentSince Aug 22, 2024 Accepting new patients
Professional Health Care of Pinellas LLC Internal Medicine CurrentSince Aug 1, 2008 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
QMC LLC Past Accepting new patients
Washington County Healthcare Authority, Inc Past Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

3487 NW 30th St
Lauderdale Lakes, FL 33311
Phone (954) 641-4200

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

8133 54th Ave N
St Petersburg, FL 33709
Phone (727) 541-4458

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Interoperability endpoints

  • Direct secure messaging: nkurtsikidze189010@orlandohealth.medalliesdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376516724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-822-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-822-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTSIKIDZE",
        "first_name": "NINO",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME100749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.