Individual provider Active NPI

Lydia Pavlova Ilieva, P.T.

  • Physical Therapist
  • Washington, DC
National Provider Identifier
1124214671
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT870718 Issued in DC
Practice address
3301 New Mexico Ave NW
Suite 318
Washington, DC 20016-3622
Phone
(202) 363-0454
NPI assigned
Sep 19, 2007
Last updated
Apr 7, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT870718 DC Primary

Addresses

Primary practice location

3301 New Mexico Ave NW
Suite 318
Washington, DC 20016-3622

Mailing address

3301 New Mexico Ave NW
Suite 318
Washington, DC 20016-3622
Phone (202) 363-0454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090223000200 DC Practitioner - Physical Therapist in Private Practice 6406911643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, 1,432 clinicians

Practice addresses (Care Compare)

3301 New Mexico Ave NW
Novacare Rehabilitation 50567 Suite 318
Washington, DC 20016-3622
Phone (202) 363-0454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc CurrentSince Oct 15, 2012 Accepting new patients
Physiotherapy Associates Inc CurrentSince Oct 15, 2012 Accepting new patients
Physiotherapy Associates Inc Physical Therapist Current Accepting new patients

Locations

3301 New Mexico Ave NW
Ste 318
Washington, DC 20016
Phone (202) 291-9266

600 Pennsylvania Ave SE
Ste 202
Washington, DC 20003
Phone (202) 543-9400

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.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1124214671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVE NW",
            "address_2": "SUITE 318",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200163622",
            "telephone_number": "202-363-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVE NW",
            "address_2": "SUITE 318",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200163622",
            "telephone_number": "202-363-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILIEVA",
        "first_name": "LYDIA",
        "middle_name": "PAVLOVA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT870718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.