OTAR MICHAEL TAKTAKISHVILI MD
NPI 1346407129
Emergency Medicine in Mineola, NY
About Otar Michael Taktakishvili Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OTAR MICHAEL TAKTAKISHVILI MD (NPI 1346407129) is an individual emergency medicine provider in Mineola, New York, licensed in Connecticut (054323) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Otar Michael Taktakishvili Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Otar Taktakishvili reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Norwalk, CT 06850
- Reassigned Medicare billing, Connecticut enrollment
- 113 clinicians in this Medicare group
Bridgeport, CT 06610
- Reassigned Medicare billing, Connecticut enrollment
- 219 clinicians in this Medicare group
Danbury, CT 06810
- Reassigned Medicare billing, Connecticut enrollment
- 155 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
MINEOLA, NY 11501
MINEOLA, NY 11501
MINEOLA, NY 11501
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 Taktakishvili's NPI number?
The NPI number for Otar Taktakishvili is 1346407129. It was assigned to this individual provider in the NPPES registry on May 20, 2008.
Where is Otar Taktakishvili located?
Otar Taktakishvili practices at 259 1st St Emergency Department, Mineola, NY 11501. The listed phone number is (516) 663-2727.
What is Otar Taktakishvili's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Otar Taktakishvili enrolled in Medicare?
Yes. Otar Taktakishvili is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Otar Taktakishvili's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Otar Taktakishvili reassigns Medicare benefits to 3 organizations: Norwalk Hospital Association (Norwalk, CT), Bridgeport Hospital (Bridgeport, CT) and Danbury Hospital (Danbury, CT). 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 Taktakishvili's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Otar Taktakishvili was last updated on August 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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 Michael Taktakishvili, MD · NPI 1346407129
Emergency Medicine physician in Mineola, New York. Individual provider, active in the CMS NPPES registry since May 20, 2008.
## Identity
- **NPI:** 1346407129 (Entity type: Individual)
- **Enumerated:** May 20, 2008
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 054323 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 259 1ST ST, EMERGENCY DEPARTMENT, Mineola, NY 11501-3957
- **Phone:** (516) 663-2727 · **Fax:** (516) 663-2727
## 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): Norwalk Hospital Association (NPI 1427041581, Norwalk, CT); Bridgeport Hospital (NPI 1649260845, Bridgeport, CT); Danbury Hospital (NPI 1184649667, Danbury, CT) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 19, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1346407129) · Data from the CMS NPPES public registry.