Organization Active NPI

Lefrak City Family Care,PC

  • Family Medicine Physician
  • Corona, NY
National Provider Identifier
1477574119
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
223885 Issued in NY
Legal business name
LEFRAK CITY FAMILY CARE,PC
Practice address
9815 Horace Harding Expy
Corona, NY 11368-4249
Phone
(718) 699-8500
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Izolda Mikhaylov, DONPI 1093734055
Title
Medical Director
Phone
(718) 469-0890

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 223885 NY Primary

Addresses

Primary practice location

9815 Horace Harding Expy
Corona, NY 11368-4249

Mailing address

785 Van Dam St
Valley Stream, NY 11581-3523
Phone (718) 469-0890

Other identifiers 1

IdentifierTypeStateIssuer
02313197MedicaidNY

Other names 1

  • dr.izolda mikhaylov Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250305002938 NY Part B Supplier - Clinic/Group Practice 9830610955 Receives reassigned benefits from 2 practitioners
Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory

Locations

6254 97th Pl
Ste B2
Rego Park, NY 11374
Phone (718) 699-8500

Practitioners & affiliated clinicians

Practitioners 6

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477574119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 VAN DAM ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813523",
            "telephone_number": "718-469-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 HORACE HARDING EXPY",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684249",
            "telephone_number": "718-699-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEFRAK CITY FAMILY CARE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIKHAYLOV",
        "authorized_official_first_name": "IZOLDA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-469-0890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "223885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02313197",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dr.izolda mikhaylov",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.