Individual provider Active NPI

Ilona Mushailova

  • Case Manager/Care Coordinator
  • Brooklyn, NY
National Provider Identifier
1376044792
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1158 45TH St
Brooklyn, NY 11219-2059
Phone
(718) 480-5566
Fax
(718) 480-5568
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

1158 45TH St
Brooklyn, NY 11219-2059

Mailing address

1158 45TH St
Brooklyn, NY 11219-2059
Phone (718) 480-5566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231209000091 NY Practitioner - Qualified Audiologist 6507215019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Works Audiology PCGroup PAC ID 7517854524, 15 clinicians

Practice addresses (Care Compare)

57 Southern Blvd
Suite 4
Nesconset, NY 11767-1091
Phone (631) 238-5785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003129NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Works Audiology PC CurrentSince Nov 6, 2023 Accepting new patients
Stella's Way, LLC PastSince Jul 28, 2025 Accepting new patients
Ear Works Audiology PastSince Nov 6, 2023 Accepting new patients

Locations

1100 Franklin Ave
Ste 300
Garden City, NY 11530
Phone (516) 248-0068

57 Southern Blvd
Ste 4
Nesconset, NY 11767
Phone (631) 238-5785

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": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1376044792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 45TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192059",
            "telephone_number": "718-480-5566",
            "fax_number": "718-480-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 45TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192059",
            "telephone_number": "718-480-5566",
            "fax_number": "718-480-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSHAILOVA",
        "first_name": "ILONA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.