TEAH QVAVADZE (MD) – Vascular Surgery Physician, NPI 1033523501
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
240 VASCULAR SURGERY in IL
Provider Addresses for TEAH QVAVADZE (MD)
747 N RUTLEDGE ST FL 4
SPRINGFIELD, IL 627026700
Phone: (217) 545-8000
Fax: (217) 545-1622
Type: Location
302 W Hay St Ste 140
Decatur, IL 625264168
Phone: (217) 872-2713
Fax: (217) 545-1958
Type: Location
300 2ND AVE
LONG BRANCH, NJ 077406303
Phone: (732) 923-6769
Type: Mailing
245 N 15TH ST
PHILADELPHIA, PA 19102
Phone: (215) 762-3585
Fax: (215) 762-3058
Type: Location
PO BOX 19639
SPRINGFIELD, IL 627949639
Phone: (217) 545-8000
Fax: (217) 545-2101
Type: Mailing
2109 HUGHES DR STE 400
TOLEDO, OH 436065143
Phone: (419) 291-2080
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $2,053.
Total Amount is formed as General ($2,053) + Research ($0) + Ownership ($0) = $2,053.
Last reported payment date: 2024-09-27 • Largest payer in this snapshot: Medtronic, Inc. ($934).
Total Amount
$2,053
General + Research + Ownership
Payments
23
Total payment records
General Amount
$2,053
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $934 |
| Penumbra, Inc. | $657 |
| Silk Road Medical, Inc. | $143 |
| W. L. Gore & Associates, Inc. | $125 |
| Inari Medical, Inc. | $74 |
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: 2023-10-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231003000594 | I | Vascular Surgery | IL | TBD |
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.
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 62702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | NJ | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Physician Assistant | IL | |
| - | IL | |
| Mental Health Counselor | IL | |
| - | IL | |
| Physician Assistant | IL | |
| Physician Assistant | IL |
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