Organization Active NPI

Kamilla Ismailoff, MD, PC

  • Internal Medicine Physician
  • South Richmond Hill, NY
National Provider Identifier
1356134241
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KAMILLA ISMAILOFF, MD, PC
Practice address
11014 Liberty Ave FL 1
South Richmond Hill, NY 11419-1706
Phone
(347) 414-2345
Fax
(929) 380-6020
NPI assigned
May 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
Kamilla Ismailoff, MDNPI 1992034961
Title
Owner
Phone
(347) 414-2345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X

Addresses

Primary practice location

11014 Liberty Ave FL 1
South Richmond Hill, NY 11419-1706

Mailing address

6910 108TH St Apt 9E
Forest Hills, NY 11375-3814
Phone (347) 414-2345

Other names 1

  • Kamilla Ismailoff, MD, PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250820004943 NY Part B Supplier - Clinic/Group Practice 3870093271 Receives reassigned benefits from 2 practitioners
Practice locations: South Richmond Hill, NY

National Provider Directory

National Provider Directory

Locations

11014 Liberty Ave
#1
South Richmond Hill, NY 11419
Phone (347) 414-2345

11014 Liberty Ave
South Richmond Hill, NY 11419
Phone (347) 414-2345

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1356134241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 108TH ST APT 9E",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753814",
            "telephone_number": "347-414-2345",
            "fax_number": "929-380-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11014 LIBERTY AVE FL 1",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191706",
            "telephone_number": "347-414-2345",
            "fax_number": "929-380-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMILLA ISMAILOFF, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "ISMAILOFF",
        "authorized_official_first_name": "KAMILLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-414-2345",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kamilla Ismailoff, MD, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.