Individual provider Active NPI

Izrail Abdurakhmanov, MD

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1023638020
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
324928 Issued in NY
Practice address
4102 13TH Ave
Brooklyn, NY 11219-1389
Phone
(718) 400-9988
Fax
(718) 408-7433
NPI assigned
Apr 20, 2020
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 324928 NY Primary

Addresses

Primary practice location

4102 13TH Ave
Brooklyn, NY 11219-1389

Mailing address

4102 13TH Ave
Brooklyn, NY 11219-1389
Phone (718) 400-9988

Other practice location 1

7559 263rd St
Glen Oaks, NY 11004-1150
Phone (718) 470-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121000319 NY Practitioner - Psychiatry 3577098003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hamaspik of Kings County, Inc.Group PAC ID 8628472768, 18 clinicians

Practice addresses (Care Compare)

4102 13TH Ave
Brooklyn, NY 11219-1389
Phone 7184008899106

4102 14TH Ave
Brooklyn, NY 11219-1401
Phone (718) 387-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
324928NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hamaspik of Kings County Current Accepting new patients
Hamaspik of Kings County, Inc. CurrentSince Oct 9, 2024 Accepting new patients

Locations

4102 14th Ave
Fl 2
Brooklyn, NY 11219

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1023638020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191389",
            "telephone_number": "718-400-9988",
            "fax_number": "718-408-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191389",
            "telephone_number": "718-400-9988",
            "fax_number": "718-408-7433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7559 263rd St",
            "address_purpose": "LOCATION",
            "city": "Glen Oaks",
            "state": "NY",
            "postal_code": "110041150",
            "country_code": "US",
            "telephone_number": "718-470-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDURAKHMANOV",
        "first_name": "IZRAIL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "324928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.