Nikol Ilyasov, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2200 Northern Blvd
Greenvale, NY 11548-1219

Phone

(877) 896-9301

NPI assigned

Sep 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

North Shore-Lij Medical PC 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score

6.36 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

21.21

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  NY

  Medicare reassignment Care Compare group
• Comprehensive Medical Services New York 2008, PLLC

  • Internal Medicine Physician
  • Lynbrook, NY
  • NPI 1134454960

  NY

  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1386367142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NORTHERN BOULVARD",
            "address_2": "SUITE 150",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "11548",
            "telephone_number": "877-896-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NORTHERN BLVD",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481219",
            "telephone_number": "877-896-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYASOV",
        "first_name": "NIKOL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Shakira Hamid, NURSE PRACTITIONER
• Lenah Hanno
• Andrew John Hasenzahl, MD, MPH
• Dara Ann Horowitz, M.S OTR/L
• Wei Huang-Parise, DDS
• Irene C. Lin, MD PC
• Ramon Jordan Jackson III, MD
• John a Venditto MD PC
• JPK Anesthesia Services PC
• Davina Kahen, RDN

• All providers in Greenvale, NY
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.