Teymuraz Datikashvili, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

211676 Issued in NY

Practice address

10825 63Rd Ave
1St FL
Forest Hills, NY 11375-1342

Phone

(718) 896-2011

NPI assigned

May 16, 2006

Last updated

May 19, 2016By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physical Medicine and RehabilitationAlso: Pain Management

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• United Medical Diagnostic Services P.C.

  • Physical Medicine & Rehabilitation Physician
  • Woodmere, NY
  • NPI 1457461865
  Medicare reassignment NPD Authorized official
• Summit Health

  • Internal Medicine Physician
  • Bellerose, NY
  • NPI 1083747463
  NPD
• Intermed Care PC

  • Legal Medicine
  • Brooklyn, NY
  • NPI 1144235516
  NPD (past)
• Kaplan & Gottlieb DC P.C

  • Chiropractor
  • Brooklyn, NY
  • NPI 1811149479
  NPD (past)
• Middletown Health Wellness Chiropractic PC

  • Chiropractor
  • Middletown, NY
  • NPI 1306601570
  NPD (past)
• Nitin D.Narkhede, MD,LLC

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1285826693
  NPD (past)
• Ny Family Medical Docs PC

  • Family Medicine Physician
  • Woodhaven, NY
  • NPI 1992204903
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1952353161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 FORDHAM LN",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 63RD AVE",
            "address_2": "1ST FL",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751342",
            "telephone_number": "718-896-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATIKASHVILI",
        "first_name": "TEYMURAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "211676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "G100007358",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharla Daniels-Stovall, M.S.
• Alice Dankman, OD
• Alyssa Daparma, M.A., CCC-SLP
• Nyima Darboe
• Joaquim Dasilva
• Renae Datkhayev, FNP
• David C. Mehl DPM PC (Forest Hills Family Foot Care)
• David Krumholz MD PC
• David Schwartz and Debra Blum DDS PC (Schwartz and Blum)
• David Tavdy Medical Care PC

• Physical Medicine & Rehabilitation Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.