NPIMap

Individual provider Active NPI

Iiya Smuglin

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1265484802
Registry record updated Feb 19, 2008
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Nov 20, 2022.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
221943 Issued in NY
Practice address
392 Bedford Park Blvd
Bronx, NY 10458-2415
Phone
(718) 364-0100
Fax
(718) 295-9220
NPI assigned
May 16, 2006
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 221943 NY Primary

Addresses

Primary practice location

392 Bedford Park Blvd
Bronx, NY 10458-2415

Mailing address

392 Bedford Park Blvd
Bronx, NY 10458-2415
Phone (718) 364-0100

Other identifiers 1

IdentifierTypeStateIssuer
0276790MedicaidNY

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Medical Plaza P.C. PastSince Nov 1, 2005 Accepting new patients
Doctor on Wheels Medical PC Past Accepting new patients
Nassau Gastroenterology Associates, P.C. Past Accepting new patients
Ez Medhealth Care PC Past Accepting new patients
Galaxy Medical PC PastSince May 1, 2013 Accepting new patients
Good Choice Medical PC PastSince May 23, 2012 Accepting new patients
Suny Downstate Medical Center PastSince Nov 1, 2017 Accepting new patients
Doctor Medical of Ny PC Past Accepting new patients
Great City Medical PC PastSince Oct 31, 2017 Accepting new patients

Organizations & group practices 9

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1265484802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 BEDFORD PARK BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104582415",
            "telephone_number": "718-364-0100",
            "fax_number": "718-295-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 BEDFORD PARK BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104582415",
            "telephone_number": "718-364-0100",
            "fax_number": "718-295-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMUGLIN",
        "first_name": "IIYA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276790",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.