Ivan Tsutskiridze, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD444322 Issued in PA

Practice address

333 Cottman Ave
Philadelphia, PA 19111-2434

Phone

(215) 728-2844

Fax

(215) 214-1425

NPI assigned

Jul 16, 2006

Last updated

Apr 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Inhospital Physicians Corp

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1073971750
  Medicare reassignment NPD
• Pinnacle Health Hospitalist Services LLC

  • Hospitalist Physician
  • Harrisburg, PA
  • NPI 1023458148

  Internal Medicine

  Medicare reassignment NPD
• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427

  Internal Medicine

  Medicare reassignment NPD
• Suburban Medical Group LLC

  • Family Medicine Physician
  • East Norriton, PA
  • NPI 1710355029

  Internal Medicine

  Medicare reassignment NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Anesthesiology Associates

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment NPD
• Temple Physicians Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1942444088

  Internal Medicine

  Medicare reassignment NPD
• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Surgical Associates Holme

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Pennsylvania, P.C.

  • Internal Medicine Physician
  • Somerset, PA
  • NPI 1639464308
  Medicare reassignment
• Pinnacle Health Medical Services

  dba Pinnacle Health Inpatient Pain Management

  • Pain Medicine Physician
  • Harrisburg, PA
  • NPI 1154752228
  NPD
• Pinnacle Health Medical Services

  dba UPMC Gastroenterology Associates of Central PA

  • Gastroenterology Physician
  • Mechanicsburg, PA
  • NPI 1295552073
  NPD
• Temple Faculty Practice Plan, Inc

  dba Temple Faculty Neurosurgical Associates

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1902389646
  NPD
• Temple Physician Inc.

  • Internal Medicine Physician
  • Feasterville Trevose, PA
  • NPI 1174497366
  NPD

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1871510842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-728-2844",
            "fax_number": "215-214-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-728-2844",
            "fax_number": "215-214-1425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 Central Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112442",
            "country_code": "US",
            "telephone_number": "215-728-2276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSUTSKIRIDZE",
        "first_name": "IVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "9781",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD444322",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD444322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE IBC",
            "identifier": "3865276000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026484200001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH DAKOTA BLUE SHIELD",
            "identifier": "24668",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2669208",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13141",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Tsou, MD
• Walter H Tsou, MD, MPH
• Eric S Tsu, PHARM D
• Jonathan Tsui, MD
• Liliya Tsuker
• Nakako Tsutsui, MA
• Boris Tsypenyuk
• Melanie Tsyryulnikov
• Maya Tsysina, M.D.
• TTC Routinerecovery, LLC

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.