DR. MALKHAZI MIKADZE MD
NPI 1033150099
Pediatrics - Pediatric Emergency Medicine in Hackensack, NJ
About Dr. Malkhazi Mikadze Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MALKHAZI MIKADZE MD (NPI 1033150099) is an individual pediatric emergency medicine provider in Hackensack, New Jersey, licensed in New Jersey (25MA07954800) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Malkhazi Mikadze Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Malkhazi Mikadze reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Livingston, NJ 07039
- Reassigned Medicare billing, New Jersey enrollment
- 1,913 clinicians in this Medicare group
Somerset, NJ 08873
- Reassigned Medicare billing, New Jersey enrollment
- 1,557 clinicians in this Medicare group
Red Bank, NJ 07701
- Reassigned Medicare billing, New Jersey enrollment
- 2,844 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HACKENSACK, NJ 07601
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Malkhazi Mikadze's NPI number?
The NPI number for Malkhazi Mikadze is 1033150099. It was assigned to this individual provider in the NPPES registry on June 9, 2006.
Where is Malkhazi Mikadze located?
Malkhazi Mikadze practices at 30 Prospect Ave Pediatrics Dept, Hackensack, NJ 07601. The listed phone number is (201) 996-2000.
What is Malkhazi Mikadze's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.
Is Malkhazi Mikadze enrolled in Medicare?
Yes. Malkhazi Mikadze is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Malkhazi Mikadze's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Malkhazi Mikadze reassigns Medicare benefits to 3 organizations: Rwjbh Observation Associates LLC (Livingston, NJ), Rwjbh Emergency Medicine Associates, LLC (Somerset, NJ) and Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Malkhazi Mikadze's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Malkhazi Mikadze accept?
Health plans from Oscar Health list Malkhazi Mikadze as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Malkhazi Mikadze was last updated on January 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Malkhazi Mikadze, MD · NPI 1033150099
Pediatric Emergency Medicine physician in Hackensack, New Jersey. Individual provider, active in the CMS NPPES registry since June 9, 2006.
## Identity
- **NPI:** 1033150099 (Entity type: Individual)
- **Enumerated:** June 9, 2006
- **Primary specialty:** Pediatrics - Pediatric Emergency Medicine · taxonomy 2080P0204X
- **State license:** 25MA07954800 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 30 PROSPECT AVE, PEDIATRICS DEPT, Hackensack, NJ 07601-1914
- **Phone:** (201) 996-2000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Rwjbh Observation Associates LLC (NPI 1760095806, Livingston, NJ); Rwjbh Emergency Medicine Associates, LLC (NPI 1912510041, Somerset, NJ); Hackensack Meridian Health Medical Group - Specialty Care PC (NPI 1215989249, Red Bank, NJ) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 2, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1033150099) · Data from the CMS NPPES public registry.