Individual provider Active NPI

Tornike Zabakhidze, M.D

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1780475962
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
3018818 Issued in MA
Practice address
736 Cambridge Street
Boston, MA 02135
Phone
(617) 779-6342
NPI assigned
May 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 3018818 MA Primary

Addresses

Primary practice location

736 Cambridge Street
Boston, MA 02135

Mailing address

736 Cambridge Street
Boston, MA 02135
Phone (617) 779-6342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20260421001556 MA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1557837143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3018818MAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1780475962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-779-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-779-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZABAKHIDZE",
        "first_name": "TORNIKE",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "3018818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.