RUSUDAN DEDIASHVILI CHIROPRACTIC CORP.
NPI 1770756892
Chiropractor in Van Nuys, CA
About Rusudan Dediashvili Chiropractic Corp. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RUSUDAN DEDIASHVILI CHIROPRACTIC CORP. (NPI 1770756892) is a healthcare organization registered as a chiropractor in Van Nuys, California and active in the NPI registry since April 2008. The organization lists Rusudan Dediashvili, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rusudan Dediashvili Chiropractic Corp. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Rusudan Dediashvili Chiropractic Corp., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Rusudan Dediashvili Chiropractic Corp.'s NPI number?
The NPI number for Rusudan Dediashvili Chiropractic Corp. is 1770756892. It was assigned to this organization in the NPPES registry on April 9, 2008.
Where is Rusudan Dediashvili Chiropractic Corp. located?
Rusudan Dediashvili Chiropractic Corp. is located at 13760 Victory Blvd, Van Nuys, CA 91401. The listed phone number is (818) 922-7713.
What is Rusudan Dediashvili Chiropractic Corp.'s specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Rusudan Dediashvili Chiropractic Corp. enrolled in Medicare?
Yes. Rusudan Dediashvili Chiropractic Corp. is registered in the Medicare PECOS enrollment system.
When is Rusudan Dediashvili Chiropractic Corp.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Rusudan Dediashvili Chiropractic Corp.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Rusudan Dediashvili Chiropractic Corp.. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Rusudan Dediashvili Chiropractic Corp. was last updated on May 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Rusudan Dediashvili Chiropractic Corp. · NPI 1770756892
Chiropractor organization in Van Nuys, California. Organization record, active in the CMS NPPES registry since April 9, 2008.
## Identity
- **NPI:** 1770756892 (Entity type: Organization)
- **Enumerated:** April 9, 2008
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Rusudan Dediashvili, PRESIDENT
## Practice location
- **Address:** 13760 VICTORY BLVD, Van Nuys, CA 91401-2324
- **Phone:** (818) 922-7713 · **Fax:** (323) 965-1411
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 28, 2020
- **Other identifiers:** Medicaid 7723436 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1770756892) · Data from the CMS NPPES public registry.