NPIMap

Organization Active NPI

Atlantic Endocrinology and Diabetes PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Rego Park, NY
National Provider Identifier
1407059199
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ATLANTIC ENDOCRINOLOGY AND DIABETES PC
Practice address
9725 63Rd Dr
Rego Park, NY 11374-2229
Phone
(718) 275-2900
Fax
(718) 275-2944
NPI assigned
Jun 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Stella Ilyayeva, MDNPI 1619082625
Title
MD
Phone
(718) 275-2900

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

9725 63Rd Dr
Rego Park, NY 11374-2229

Mailing address

9725 63Rd Dr
Rego Park, NY 11374-2229
Phone (718) 275-2900

Other identifiers 2

IdentifierTypeStateIssuer
02148396MedicaidNY
03436793MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000145 NY Part B Supplier - Clinic/Group Practice 8325952971 Receives reassigned benefits from 11 practitioners
Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1407059199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 63RD DR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742229",
            "telephone_number": "718-275-2900",
            "fax_number": "718-275-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 63RD DR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742229",
            "telephone_number": "718-275-2900",
            "fax_number": "718-275-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC ENDOCRINOLOGY AND DIABETES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "ILYAYEVA",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-275-2900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02148396",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03436793",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.