NPIMap

Individual provider Active NPI

Izolda Mikhaylov, DO

  • Family Medicine Physician
  • Rego Park, NY
National Provider Identifier
1093734055
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
223885 Issued in NY
Practice address
6254 97TH PL Ste 2B
Rego Park, NY 11374-1354
Phone
(718) 595-1166
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 223885 NY Primary

Addresses

Primary practice location

6254 97TH PL Ste 2B
Rego Park, NY 11374-1354

Mailing address

6254 97TH PL Ste 2B
Rego Park, NY 11374-1354
Phone (718) 595-1166

Other identifiers 1

IdentifierTypeStateIssuer
02313197MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624001699 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1153307814 Reassigns benefits to 2 organizations
Practice locations: Corona, NY; Rego Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
Lefrak City Family Care PCGroup PAC ID 9830610955, 2 clinicians

Practice addresses (Care Compare)

1220 Ave P
Brooklyn, NY 11229-1009
Phone (718) 376-1004

6254 97TH PL
Suite B2
Rego Park, NY 11374-1354
Phone (718) 699-8500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223885NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Remed Medical, P. C. CurrentSince Nov 17, 2024 Accepting new patients
New York University CurrentSince Aug 1, 2025 Accepting new patients
Lefrak City Family Care,PC Family Medicine CurrentSince Jan 21, 2025 Accepting new patients
New York University CurrentSince Aug 1, 2025 Accepting new patients
Larisa Veksman D.O P.C Past Accepting new patients
Brooklyn Medical Associate, LFPC Past Accepting new patients
Bright Pharmacy LLC Past Accepting new patients
Intermed Care PC Past Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

3048 Brighton 1st St
Brooklyn, NY 11235
Phone (718) 368-1170

3048 Brighton 1st St
Ste 1
Brooklyn, NY 11235
Phone (718) 368-1170

1220 Avenue P
Brooklyn, NY 11229
Phone (718) 375-7546

6254 97th Pl
Ste B2
Rego Park, NY 11374
Phone (718) 699-8500

6254 97th Pl
Ste 2B
Rego Park, NY 11374
Phone (718) 595-1166

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: imikhaylov744939@nyumc.direct-ci.com

Organizations & group practices 8

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1093734055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6254 97TH PL STE 2B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741354",
            "telephone_number": "718-595-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6254 97TH PL STE 2B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741354",
            "telephone_number": "718-595-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAYLOV",
        "first_name": "IZOLDA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "223885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02313197",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.