Active NPI
Svetlana Ilizarov, M.D.
- Physical Medicine & Rehabilitation Physician
- East Setauket, NY
National Provider Identifier
1093722183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 215268
- Practice address
- 181 Belle Mead Rd
East Setauket, NY 11733-3495 - Phone
- (631) 444-6996
- NPI assigned
- Aug 1, 2006
- Last updated
- Jul 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 215268 | NY | Primary |
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 215268 | NY |
Addresses
Primary practice location
181 Belle Mead Rd
East Setauket, NY 11733-3495
Mailing address
HSC 18 Room 020 Department of Orthopaedics
Stony Brook University Medical Center
Stony Brook, NY 11794-0001
Phone (631) 444-6996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2090022 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2599
Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurology Associates of Stony Brook, University Faculty Practice Corpo | Current | Accepting new patients | |
| Stony Brook Orthopaedic Associates, University Faculty Practice Corpor | Past | Accepting new patients | |
| University Associates in Obstetrics & Gynecology, University Faculty P | Past | Accepting new patients |
Locations
225 W Montauk Hwy
Hampton Bays, NY 11946
Phone (631) 723-2316
181 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 444-0624
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Organizations & group practices 3
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.
-
- Neurology Physician
- Stony Brook, NY
- NPI 1699720888
-
- Orthopaedic Surgery Physician
- Stony Brook, NY
- NPI 1154377638
-
- Obstetrics & Gynecology Physician
- Stony Brook, NY
- NPI 1538114723
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Stony Brook Southampton Hospital
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217116800000",
"number": "1093722183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HSC 18 ROOM 020 DEPARTMENT OF ORTHOPAEDICS",
"address_2": "STONY BROOK UNIVERSITY MEDICAL CENTER",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "631-444-6996",
"fax_number": "631-444-7671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 BELLE MEAD RD",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117333495",
"telephone_number": "631-444-6996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILIZAROV",
"first_name": "SVETLANA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2008-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NY",
"license": "215268",
"primary": true
},
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "NY",
"license": "215268",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2090022",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.