Otar Datiashvili, MD - Medicare Emergency Medicine in Bloomington, IN

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Otar Datiashvili, MD is a medicare enrolled "Emergency Medicine" physician in Bloomington, Indiana. He graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Island Emergency Medical Services Pc, Emergency Physician Services Of New York, P.c. and his current practice location is 2651 E Discovery Pkwy, Bloomington, Indiana. You can reach out to his office (for appointments etc.) via phone at (812) 353-9515.

Otar Datiashvili is licensed to practice in Indiana (license number 01093706A) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1083096572.

Contact Information

Otar Datiashvili, MD
2651 E Discovery Pkwy,
Bloomington, IN 47408-9059
(812) 353-9515
(812) 353-9275

Map and Direction




Physician's Profile

Full NameOtar Datiashvili
GenderMale
SpecialityEmergency Medicine
Experience12 Years
Location2651 E Discovery Pkwy, Bloomington, Indiana
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Otar Datiashvili graduated from medical school in 2012
  NPI Data:
  • NPI Number: 1083096572
  • Provider Enumeration Date: 06/22/2015
  • Last Update Date: 05/15/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3678882214
  • Enrollment ID: I20191010001727

Medical Identifiers

Medical identifiers for Otar Datiashvili such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083096572NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 273598-1 (New York)Secondary
207P00000XEmergency Medicine 01093706A (Indiana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ellis HospitalSchenectady, NYHospital
Putnam Hospital CenterCarmel, NYHospital
Samaritan HospitalTroy, NYHospital
Arnot Ogden Medical CenterElmira, NYHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Island Emergency Medical Services Pc4981503513143
Emergency Physician Services Of New York, P.c.832593980489

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Otar Datiashvili allows following entities to bill medicare on his behalf.
Entity NameMary Imogene Bassett Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083664221
PECOS PAC ID: 3779488325
Enrollment ID: O20031205000553
Entity NameIsland Emergency Medical Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639160385
PECOS PAC ID: 4981503513
Enrollment ID: O20040102000662
Entity NameMary Imogene Bassett Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083664221
PECOS PAC ID: 3779488325
Enrollment ID: O20040120000834
Entity NameEmergency Physician Services Of New York, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093759847
PECOS PAC ID: 8325939804
Enrollment ID: O20040901000528
Entity NameEmergency Physician Services Of New York, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093759847
PECOS PAC ID: 8325939804
Enrollment ID: O20041001000684
Entity NameArnot Ogden Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083605661
PECOS PAC ID: 5395798417
Enrollment ID: O20061003000664
Entity NameCity Medical Of Upper East Side Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801277629
PECOS PAC ID: 0648465039
Enrollment ID: O20101111000052
Entity NameNorth Shore - Lij Medical Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053688572
PECOS PAC ID: 3375701568
Enrollment ID: O20120220000262

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Otar Datiashvili is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Otar Datiashvili, MD
250 N Shadeland Ave,
Indianapolis, IN 46219-4959

Ph: () -		Otar Datiashvili, MD
2651 E Discovery Pkwy,
Bloomington, IN 47408-9059

Ph: (812) 353-9515

Reviews and Comments


Emergency Medicine Doctors in Bloomington, IN

Ronald C Jenson, DO
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 4794 Red Oak Ln, Bloomington, IN 47401
Phone: 812-396-9620    
Dr. Robert Stone, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 514 W 2nd St, Bloomington, IN 47403
Phone: 812-353-3719    Fax: 812-353-3713
Dr. Christina M Cabott, DO
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 601 W 2nd St, Bloomington, IN 47403
Phone: 812-336-1690    Fax: 812-349-1325
Dr. John Austin Lee, MD, MPH
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408
Phone: 812-353-9515    Fax: 812-353-9275
Dr. Carlyle George Langhorn Jr., M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408
Phone: 812-353-9515    
Jonathan D Hart, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2605 E Creeks Edge Dr, Bloomington, IN 47401
Phone: 812-355-2300    Fax: 812-355-2316

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.