Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nino Kavtaradze, CRNP

Individual provider Registered Nurse · NPI 1639574841

Nino Kavtaradze, CRNP is a Nurse Practitioner in Feasterville Trevose, Pennsylvania. Qualified in 2015, 11 years ago. Practices with Infinite Medical PC, a 86-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
11
Licensed in
PA
In the registry since
2014
Specialties on file
3
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

1200 Bustleton Pike Ste 16A3
Feasterville Trevose, PA 19053-4118
Phone: (267) 574-5236
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11043 Greiner Rd, Philadelphia, PA 19116-2611 — (267) 574-5236

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP015632 (PA)
Registered Nurse Taxonomy 163W00000X · Licence RN632493 (PA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence SP015632 (PA)

Record details

NPI number1639574841
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedOctober 30, 2014
Last updated in NPPESNovember 27, 2023
Certification dateJanuary 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Infinite Medical Pc — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Feasterville Trevose