BRENDA GIVARGIDZE (PA-C) – Physician Assistant, NPI 1114740537

BRENDA GIVARGIDZE (PA-C) is a healthcare provider. based in Saint cloud, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 9119295 (FL). The NPI Number for BRENDA GIVARGIDZE (PA-C) is 1114740537

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
BRENDA GIVARGIDZE (PA-C)
NPI
1114740537
Phone
Not provided
Address
2090 OLD HICKORY TREE RD STE 107
Enumeration Date
4 November 2024
Last Update Date
18 February 2025

Doctor Profile

Medical School Name
NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Secondary Phone
-
Graduation Year
2024 (2 years ago)
PAC ID
4587184619
Group Practice PAC ID
3971591231
Professional Enrollment ID
I20250219003935
Address ID
FL330734356CO4855XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for BRENDA GIVARGIDZE (PA-C)

  • 2090 OLD HICKORY TREE RD STE 107

    SAINT CLOUD, FL 347728901

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250219003935IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34772)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971591231View full group profile
NameSpecialtyState
-FL
Physician AssistantFL
Family PracticeFL
-FL
Internal MedicineFL
Physician AssistantFL
Physician AssistantFL
Nurse PractitionerFL
Physician AssistantFL
Physician AssistantFL

Reviews

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Frequently asked questions

What federal number belongs to BRENDA GIVARGIDZE (PA-C)?
The federal identifier for BRENDA GIVARGIDZE (PA-C) is NPI 1114740537.
Does this profile mean BRENDA GIVARGIDZE (PA-C) is currently active?
Yes — BRENDA GIVARGIDZE (PA-C) appears active in the national provider directory.
What does BRENDA GIVARGIDZE (PA-C) treat or focus on?
Patients typically see BRENDA GIVARGIDZE (PA-C) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
What location shows for BRENDA GIVARGIDZE (PA-C)?
We surface Saint Cloud, Florida for BRENDA GIVARGIDZE (PA-C) based on available NPPES addresses.
How can I contact BRENDA GIVARGIDZE (PA-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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