Gvantsa Didebulidze, MD - Medicare Internal Medicine in Brockton, MA

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Gvantsa Didebulidze, MD is a medicare enrolled "Internal Medicine" physician in Brockton, Massachusetts. She graduated from medical school in 2009 and has 16 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Lahey Clinic Inc, Mass General Brigham Medical Group Northern Massachusetts Inc and her current practice location is 63 Main St, Brockton, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (508) 559-6699.

Gvantsa Didebulidze is licensed to practice in Massachusetts (license number 257775) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1730474644.

Contact Information

Gvantsa Didebulidze, MD
63 Main St,
Brockton, MA 02301-4042
(508) 559-6699
(508) 559-5073

Map and Direction




Physician's Profile

Full NameGvantsa Didebulidze
GenderFemale
SpecialityInternal Medicine
Experience16 Years
Location63 Main St, Brockton, Massachusetts
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Gvantsa Didebulidze graduated from medical school in 2009
  NPI Data:
  • NPI Number: 1730474644
  • Provider Enumeration Date: 06/20/2011
  • Last Update Date: 05/19/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0143441758
  • Enrollment ID: I20141024000170

Medical Identifiers

Medical identifiers for Gvantsa Didebulidze such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1730474644NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 257775 (Massachusetts)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Partners Healthcare At Home - Home CareWaltham, MAHome health agency
North Shore Medical Center -Salem, MAHospital
Massachusetts General HospitalBoston, MAHospital
Lahey Hospital & Medical Center, BurlingtonBurlington, MAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lahey Clinic Inc22643365281268
Mass General Brigham Medical Group Northern Massachusetts Inc3577467224552

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gvantsa Didebulidze allows following entities to bill medicare on her behalf.
Entity NameLahey Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538194980
PECOS PAC ID: 2264336528
Enrollment ID: O20031120000097
Entity NameBrockton Neighborhood Health Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225085319
PECOS PAC ID: 3870491699
Enrollment ID: O20031230000558
Entity NameLahey Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063447316
PECOS PAC ID: 2264336528
Enrollment ID: O20040629001269
Entity NameMass General Brigham Medical Group Northern Massachusetts Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588606123
PECOS PAC ID: 3577467224
Enrollment ID: O20050429000668

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gvantsa Didebulidze is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Gvantsa Didebulidze, MD
63 Main St,
Brockton, MA 02301-4042

Ph: (508) 559-6699		Gvantsa Didebulidze, MD
63 Main St,
Brockton, MA 02301-4042

Ph: (508) 559-6699

Reviews and Comments


Internal Medicine Doctors in Brockton, MA

Louis D. Gottlieb, M.D.
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 680 Centre St, Managed Care, Brockton, MA 02302
Phone: 508-941-7065    Fax: 508-941-6373
Gloria Ibarra, M.D.
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 63 Main St, Brockton, MA 02301
Phone: 508-559-6699    Fax: 508-559-5073
Elsie Varughese, M.D.
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 63 Main St, Brockton, MA 02301
Phone: 508-559-6699    Fax: 508-583-4649
Jane G Butlin, MD
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 1 Pearl St, Suite 2200, Brockton, MA 02301
Phone: 508-897-6051    Fax: 508-897-6096
Jacob Mandell, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 680 Centre St, Brockton Hospital, Brockton, MA 02302
Phone: 508-941-7150    
Renu B Prakash, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 235 N Pearl St, Brockton, MA 02301
Phone: 617-789-3000    
Jolly Abeskheron, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1 Pearl St, Suite 1000, Brockton, MA 02301
Phone: 508-897-6060    Fax: 508-897-6063

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.