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DR. KONSTANTIN DZAMASHVILI MD NPI 1174529085


NPI Information

NPI: 1174529085
Provider Name: DR. KONSTANTIN DZAMASHVILI, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

Organization: FLORIDA NEUROLOGY GROUP P L

PECOS Registration: Yes

Address:
12670 WHITEHALL DR
FORT MYERS, FL
ZIP 33907
Phone: (239) 936-3554
Get Directions

DR. Konstantin Dzamashvili, MD is a neurology psychiatry neurology in Fort Myers, FL with 51 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Konstantin Dzamashvili, MD NPI is 1174529085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12670 WHITEHALL DR
FORT MYERS, FL
ZIP 33907-619
Phone: (239) 936-3554
Fax: (239) 936-8993

The NPI 1174529085 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Needle measurement and recording of electrical activity of muscles of arm or leg complete study (HCPCS:95886)
  • Measurement and recording of brain wave (EEG) activity, awake and asleep (HCPCS:95819)
  • Nerve transmission studies, 7-8 studies (HCPCS:95910)

The enumeration date for this NPI number is 6/24/2005 and was last updated on 11/18/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurology036093821ILLINOISNo
22084V0102XPsychiatry & NeurologyVascular Neurology036093821ILLINOISNo
32084N0400XPsychiatry & NeurologyNeurologyME126918FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1036093821OTHERILLINOISSTATE LICENSE
2206147046OTHERMEDICARE PTAN (INDIVIDUAL)
3036093821MEDICAIDILLINOIS
4CA4748OTHERMEDICARE RAILROAD (GROUP)
5P00904562OTHERMEDICARE RAILROAD (PROVIDER)
6IQ302ZMEDICARE PINFLORIDA
7G74924MEDICARE UPIN
8206147OTHERMEDICARE PTAN (GROUP)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.