DR. KONSTANTIN DZAMASHVILI (MD) – Neurology Physician, NPI 1174529085

DR. KONSTANTIN DZAMASHVILI (MD) is a healthcare provider. based in Fort myers, Florida. specializing in NEUROLOGY. They hold the professional credentials MD. They hold a License No. 036093821 (IL). The NPI Number for DR. KONSTANTIN DZAMASHVILI (MD) is 1174529085

Main info

Male
53 Years Of Experience
Name
DR. KONSTANTIN DZAMASHVILI (MD)
NPI
1174529085
Phone
(239) 936-3554
Address
12670 WHITEHALL DR
Enumeration Date
24 June 2005
Last Update Date
18 November 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9419363554
Graduation Year
1973 (53 years ago)
PAC ID
7517953607
Group Practice PAC ID
0840286407
Professional Enrollment ID
I20160812001746
Address ID
FL339073619FO12670DRXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

1,847 NEUROLOGY in FL

Provider Addresses for DR. KONSTANTIN DZAMASHVILI (MD)

  • 12670 WHITEHALL DR

    FORT MYERS, FL 339073619

    Phone: (239) 936-3554

    Fax: (239) 936-8993

    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)

CMS reports 260 Open Payments records for all available years, with a total value of $5,709.

Total Amount is formed as General ($5,709) + Research ($0) + Ownership ($0) = $5,709.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Alexion Pharmaceuticals, Inc. ($524).

Total Amount

$5,709

General + Research + Ownership

Payments

260

Total payment records

General Amount

$5,709

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-08-12

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
I20160812001746INeurologyFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J0585Injection, onabotulinumtoxina, 1 unit5,74512$0
99214Established patient office or other outpatient visit, 30-39 minutes779551$0
95886Needle measurement of electrical activity in arm or leg muscles, complete study269121$0
99205New patient office or other outpatient visit, 60-74 minutes217217$0
96372Injection of drug or substance under skin or into muscle11461$0
View full utilization report →

Insurance plans in this area (ZIP 33907)

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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: 0840286407View full group profile
NameSpecialtyState
N E U R O L O G YFL
N E U R O L O G YFL
N E U R O L O G YFL
N E U R O L O G YFL
-FL
N E U R O L O G YFL
N E U R O L O G YIN
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. KONSTANTIN DZAMASHVILI (MD)?
DR. KONSTANTIN DZAMASHVILI (MD) — NPI 1174529085 — is the standard way to identify this listing.
Does the file indicate DR. KONSTANTIN DZAMASHVILI (MD) is practicing under active NPI?
Directory data currently reports DR. KONSTANTIN DZAMASHVILI (MD) as active.
What healthcare role does DR. KONSTANTIN DZAMASHVILI (MD) hold?
Scheduling teams often label DR. KONSTANTIN DZAMASHVILI (MD) under Neurology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. KONSTANTIN DZAMASHVILI (MD)?
DR. KONSTANTIN DZAMASHVILI (MD)'s geographic hint is Fort Myers, Florida in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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