Yelizaveta Valeriyevna Makhatadze, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E4609 Issued in AR

Practice address

7301 Rogers Ave
Fort Smith, AR 72903-4100

Phone

(479) 314-5175

Fax

(479) 314-5185

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR, MO2 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

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
• Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
• Sequoyah County-City of Sallisaw Hospital Authorit Hospital, Sallisaw, OK, CCN 370112
• Mercy Hospital Paris Hospital, Paris, AR, CCN 041300
• Eastern Oklahoma Medical Center Hospital, Poteau, OK, CCN 371337

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 and National Provider Directory roles.

• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment Care Compare group
• Mercy Aco Clinical Services Inc

  • Neurology Physician
  • Chesterfield, MO
  • NPI 1063965093

  AR

  Medicare reassignment NPD

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

• Baptist Health Regional Hospitals

  dba Baptist Health - Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1710463146
  Care Compare affiliation
• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation
• Mercy Hospital Paris

  • Critical Access Hospital
  • Paris, AR
  • NPI 1760453633
  Care Compare affiliation
• Leflore County Hospital Authority

  dba Mountain Gateway Senior Health

  • Psychiatric Hospital Unit
  • Poteau, OK
  • NPI 1184997447
  Care Compare affiliation
• Leflore County Hospital Authority

  dba Eastern Oklahoma Medical Center

  • Critical Access Hospital
  • Poteau, OK
  • NPI 1396767158
  Care Compare affiliation
• Sequoyah County City of Sallisaw Hospital Authority

  dba Sequoyah Memorial Hospital

  • Rural Acute Care Hospital
  • Sallisaw, OK
  • NPI 1972539567
  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1891744876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-5175",
            "fax_number": "479-314-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-5175",
            "fax_number": "479-314-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHATADZE",
        "first_name": "YELIZAVETA",
        "middle_name": "VALERIYEVNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E4609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159847001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200116350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack L Magness Jr., MD
• Joann Mahan, APRN
• Bert G Main, DO
• Sara Maitland, SLP
• Maria Altaf Majeed, MD
• Malcolm R Hutchins O D P a
• Oksana Maliar, MD
• Bethany Malinka, M.S., CF-SLP
• Adam Malone, MHPP
• Stephanie Malone, LAC

• Family Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.