LASHA KHETSURIANI
NPI 1538284435
Psychiatry & Neurology - Psychiatry in Bronx, NY
About Lasha Khetsuriani NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LASHA KHETSURIANI (NPI 1538284435) is an individual psychiatry provider in Bronx, New York, licensed in New York (235867) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lasha Khetsuriani is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Lasha Khetsuriani reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Plattsburgh, NY 12901
- Reassigned Medicare billing, New York enrollment
- 675 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10461 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.
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 Lasha Khetsuriani's NPI number?
The NPI number for Lasha Khetsuriani is 1538284435. It was assigned to this individual provider in the NPPES registry on March 20, 2007.
Where is Lasha Khetsuriani located?
Lasha Khetsuriani practices at 1500 Waters Pl, Bronx, NY 10461. The listed phone number is (718) 931-0600.
What is Lasha Khetsuriani's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Lasha Khetsuriani enrolled in Medicare?
Yes. Lasha Khetsuriani is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Lasha Khetsuriani's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lasha Khetsuriani reassigns Medicare benefits to Champlain Valley Physicians Hospital Medical Center (Plattsburgh, NY). The 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 Lasha Khetsuriani'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 Lasha Khetsuriani was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Lasha Khetsuriani · NPI 1538284435
Psychiatry physician in Bronx, New York. Individual provider, active in the CMS NPPES registry since March 20, 2007.
## Identity
- **NPI:** 1538284435 (Entity type: Individual)
- **Enumerated:** March 20, 2007
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **State license:** 235867 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1500 WATERS PL, Bronx, NY 10461-2723
- **Phone:** (718) 931-0600
## 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:** Champlain Valley Physicians Hospital Medical Center (NPI 1033270699, Plattsburgh, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicare UPIN OTH000 (NY); Medicaid 235867 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1538284435) · Data from the CMS NPPES public registry.