OTAR DATIASHVILI MD
NPI 1083096572
Emergency Medicine in Bloomington, IN
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
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
14Medicare enrollment records show Otar Datiashvili reassigns Medicare billing to 14 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bloomington, IN 47408
- Reassigned Medicare billing, Indiana enrollment
- 783 clinicians in this Medicare group
Indianapolis, IN 46202
- Reassigned Medicare billing, Indiana enrollment
- 5,212 clinicians in this Medicare group
Leitchfield, KY 42754
- Reassigned Medicare billing, Indiana enrollment
- 77 clinicians in this Medicare group
Fort Wayne, IN 46804
- Reassigned Medicare billing, Indiana enrollment
- Medicare enrollment name: Emergency Professionals Of Indiana PC
- 404 clinicians in this Medicare group
Memphis, TN 38128
- Reassigned Medicare billing, Tennessee enrollment
- 250 clinicians in this Medicare group
Germantown, TN 38138
- Reassigned Medicare billing, Tennessee enrollment
- 251 clinicians in this Medicare group
Memphis, TN 38104
- Reassigned Medicare billing, Tennessee enrollment
- 253 clinicians in this Medicare group
Olive Branch, MS 38654
- Reassigned Medicare billing, Mississippi enrollment
- 96 clinicians in this Medicare group
Memphis, TN 38116
- Reassigned Medicare billing, Tennessee enrollment
- 252 clinicians in this Medicare group
Wilkes Barre, PA 18764
- Reassigned Medicare billing, Pennsylvania enrollment
- 111 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.
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.
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, INIndiana University Health Paoli Hospital
Critical Access Hospitals · Paoli, INPerry County Memorial Hospital
Critical Access Hospitals · Tell City, INMethodist Healthcare - Olive Branch Hospital
Acute Care Hospitals · Olive Branch, MSMethodist Hospitals Of Memphis
Acute Care Hospitals · Memphis, TNPhysician 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.
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.
BLOOMINGTON, IN 47408
BLOOMINGTON, IN 47408
BLOOMINGTON, IN 47408
BLOOMINGTON, IN 47408
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.
Which organizations bill Medicare for Otar Datiashvili's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Otar Datiashvili reassigns Medicare benefits to 14 organizations: Indiana University Health Southern Indiana Physicians, LLC (Bloomington, IN), Iu Health Medical Group, LLC (Indianapolis, IN), Concord Company Of Tennessee PLLC (Leitchfield, KY), Emergency Professionals Of Indiana, P.C. (Fort Wayne, IN), Methodist North Emergency Physicians, PLLC (Memphis, TN) and 9 more organizations, listed in the Medicare section above. 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 Otar Datiashvili's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Otar Datiashvili accept?
Health plans from Blue Cross Blue Shield of Arizona and 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 Methodist Hospitals Of Memphis.
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 19 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.
# Otar Datiashvili, MD · NPI 1083096572
Emergency Medicine physician in Bloomington, Indiana. Individual provider, active in the CMS NPPES registry since June 22, 2015.
## Identity
- **NPI:** 1083096572 (Entity type: Individual)
- **Enumerated:** June 22, 2015
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 01093706A (Indiana)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2651 E DISCOVERY PKWY, Bloomington, IN 47408-9059
- **Phone:** (812) 353-9515 · **Fax:** (812) 353-9275
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 14 organizations under Medicare reassignment (form CMS-855R): Indiana University Health Southern Indiana Physicians, LLC (NPI 1013953983, Bloomington, IN); Iu Health Medical Group, LLC (NPI 1326893777, Indianapolis, IN); Concord Company Of Tennessee PLLC (NPI 1649743667, Leitchfield, KY); Emergency Professionals Of Indiana, P.C. (NPI 1013951219, Fort Wayne, IN); Methodist North Emergency Physicians, PLLC (NPI 1801677083, Memphis, TN); and 9 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of New York At Stony Brook, School Of Medicine, class of 2008
## Record status
- **NPPES last updated:** March 5, 2025
- **Other identifiers:** Medicaid 03782025 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1083096572) · Data from the CMS NPPES public registry.