OTAR DATIASHVILI MD
NPI 1083096572
Emergency Medicine in Bloomington, IN

Active since June 22, 2015PECOS EnrolledAccepts Medicare Assignment
86.64/100
CMS Quality Rating
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408(812) 353-9515(812) 353-9275 Get Directions Write a Review

NPPES record last updated: March 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 5, 2025, May 15, 2024 (2 updates tracked since 2024).

About Otar Datiashvili Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OTAR DATIASHVILI MD (NPI 1083096572) is an individual emergency medicine provider in Bloomington, Indiana, licensed in Indiana (01093706A) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Indiana University Health Bloomington Hospital, and maintains a secondary practice location in North Adams.

NPPES Registry Identity

NPI1083096572
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameOTAR DATIASHVILICredential: MD
Location Address2651 E DISCOVERY PKWYBloomington, IN 47408-9059
Mailing Address250 N Shadeland AveIndianapolis, IN 46219-4959
Fax(812) 353-9275
Sole ProprietorYes
Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 2008
Enumeration DateJune 22, 2015
Last NPPES UpdateMarch 5, 20252 updates tracked since enumeration
NPPES CertifiedMarch 5, 2025
NPI 1083096572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses Licensed in IN · 01093706A Licensed in NY · 273598-1
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
2651 E DISCOVERY PKWY, Bloomington, IN 47408

Secondary Practice Location 1

Location 160 Roberts Dr Ste 313North Adams, MA 01247-3254 · Phone (413) 398-5509

Other Identifiers 1

Medicaid03782025IN

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Otar Datiashvili Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678882214
PECOS Enrollment IDI20160316000892, I20191010001727, I20240521002400, I20241226001106
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
193 services191 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
76 services76 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
16 services16 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Indiana University Health Bloomington Hospital

Acute Care Hospitals · Bloomington, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150051
Location2651 East Discovery ParkwayBloomington, IN 47408 · Monroe County
Emergency services Birthing friendly

Indiana University Health Paoli Hospital

Critical Access Hospitals · Paoli, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151306
Location642 W Hospital RdPaoli, IN 47454 · Orange County
Emergency services Birthing friendly

Perry County Memorial Hospital

Critical Access Hospitals · Tell City, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number151322
Location8885 Sr 237Tell City, IN 47586 · Perry County
Emergency services

Methodist Healthcare - Olive Branch Hospital

Acute Care Hospitals · Olive Branch, MS
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number250167
Location4250 Bethel RoadOlive Branch, MS 38654 · De Soto County
Emergency services Birthing friendly

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47408 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

86.64/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.13
Promoting Interoperability74
Improvement Activities40

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.

Student in an Organized Health Care Education/Training Program
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Pathology (Anatomic Pathology & Clinical Pathology)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Clinical Nurse Specialist
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Clinic/Center (Multi-Specialty)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Nurse Practitioner (Gerontology)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Physician Assistant
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Internal Medicine
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Psychiatry & Neurology (Psychiatry)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408

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 Otar Datiashvili's NPI number?

The NPI number for Otar Datiashvili is 1083096572. It was assigned to this individual provider in the NPPES registry on June 22, 2015.

Where is Otar Datiashvili located?

Otar Datiashvili practices at 2651 E Discovery Pkwy, Bloomington, IN 47408. The listed phone number is (812) 353-9515.

What is Otar Datiashvili's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Otar Datiashvili enrolled in Medicare?

Yes. Otar Datiashvili is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Otar Datiashvili accept?

Health plans from CareSource list Otar Datiashvili 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.

Is Otar Datiashvili affiliated with any hospitals?

According to CMS data, Otar Datiashvili is affiliated with Indiana University Health Bloomington Hospital, Indiana University Health Paoli Hospital, Perry County Memorial Hospital, Methodist Healthcare - Olive Branch Hospital and Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Otar Datiashvili was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.