Individual provider Active NPI

Elnara Ilishayev, BCBA

  • Behavior Analyst
  • Brooklyn, NY
National Provider Identifier
1063045672
Registry record updated Jan 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
P112246 Issued in NY
Practice address
1000 Ocean Pkwy Apt 3M
Brooklyn, NY 11230-3415
Phone
(347) 972-1832
NPI assigned
Feb 21, 2020
Last updated
Jan 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2022

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 NU
Behavior Analyst 103K00000X P112246 NY Primary

Addresses

Primary practice location

1000 Ocean Pkwy Apt 3M
Brooklyn, NY 11230-3415

Mailing address

1000 Ocean Pkwy Apt 3M
Brooklyn, NY 11230-3415
Phone (347) 972-1832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P112246NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Buckeye Behavioral Consulting Inc Past Accepting new patients
Encore Licensed Behavior Analyst PLLC Behavior Analyst Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678

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": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1063045672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OCEAN PKWY APT 3M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303415",
            "telephone_number": "347-972-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OCEAN PKWY APT 3M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303415",
            "telephone_number": "347-972-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILISHAYEV",
        "first_name": "ELNARA",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2022-01-08",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "P112246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.