Individual provider Active NPI

Peter Bratovanov Iliev, M.D.

  • Anesthesiology Physician
  • Jackson, MS
National Provider Identifier
1376876987
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME142378 Issued in FL
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 815-1196
Fax
(601) 984-5939
NPI assigned
Sep 14, 2009
Last updated
Jul 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 24023 MS
Anesthesiology Physician 207L00000X ME142378 FL Primary
Anesthesiology Physician 207L00000X 254809 NY

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-1196

Other identifiers 1

IdentifierTypeStateIssuer
02704031MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091125000158 NY Practitioner - Anesthesiology 8527107093 Reassigns benefits to 11 organizations
I20191210001868 FL Practitioner - Anesthesiology 8527107093 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 -24 Mitchell Ave
Binghamton, NY 13903-1617
Phone (607) 762-3131

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101

52 Harrison St
Johnson City, NY 13790-2120
Phone (607) 763-5898

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
254809NYMDAnesthesiology Physician
24023MSMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Physician Health, P.C. Anesthesiology CurrentSince Oct 1, 2025 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Sep 28, 2020 Accepting new patients
Yorkville Endoscopy, LLC CurrentSince Sep 1, 2019 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Sep 28, 2020 Accepting new patients
York Anesthesiologists PLLC Anesthesiology CurrentSince Aug 15, 2019 Accepting new patients
Greater Florida Anesthesiologists, LLC Anesthesiology Current Accepting new patients
Resource Anesthesiology Associates,PC Anesthesiology CurrentSince Jul 1, 2019 Accepting new patients
Upstate Anesthesia Services, P.C. Anesthesiology CurrentSince Apr 28, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology Current Accepting new patients
Westchester Medical Center Advanced Physician Services PC Anesthesiology CurrentSince Mar 1, 2018 Accepting new patients
Greater Florida Anesthesiologists, LLC Anesthesiology CurrentSince Nov 4, 2019 Accepting new patients
Singular Anesthesia Services, PLLC Anesthesiology CurrentSince Sep 9, 2019 Accepting new patients
Lynbrook Anesthesia Services, PC Anesthesiology CurrentSince Jul 11, 2019 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC Anesthesiology Current Accepting new patients
Greater Florida Anesthesiologists, LLC Anesthesiology CurrentSince Nov 4, 2019 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Nov 4, 2024 Accepting new patients
Bronx Anesthesia Services, PC Anesthesiology Past Accepting new patients
Resource Anesthesiology Associates of CT PC Anesthesiology Past Accepting new patients

Locations (25 of 28)

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

7700 W Sunrise Blvd
#31
Plantation, FL 33322

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

5500 Broadway
Ste A
Bronx, NY 10463
Phone (718) 543-3635

55 Palmer Ave
Bronxville, NY 10708
Phone (914) 787-3136

88 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 591-8400

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

600 Mamaroneck Ave
Ste 301
Harrison, NY 10528
Phone 9147238100116

4604 31st Ave
Long Island City, NY 11103
Phone (718) 545-2100

198 Canal St
Ste 501
New York, NY 10013
Phone (212) 219-8010

201 E 93rd St
New York, NY 10128
Phone (917) 281-0100

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Networks

  • Freedom Health HMO Network

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 1

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": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1376876987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-1196",
            "fax_number": "601-984-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-1196",
            "fax_number": "601-984-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILIEV",
        "first_name": "PETER",
        "middle_name": "BRATOVANOV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-14",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "24023",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME142378",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "254809",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02704031",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.