Individual provider Active NPI

Yakhiyel Pilosov

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1548477466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
199924 Issued in NY
Practice address
15 Denise CT
Staten Island, NY 10312-5802
Phone
(718) 605-6887
NPI assigned
May 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 199924 NY Primary

Addresses

Primary practice location

15 Denise CT
Staten Island, NY 10312-5802

Mailing address

68-80 Schermerhorn Street
Brooklyn, NY 11201
Phone (718) 858-7200

Other identifiers 1

IdentifierTypeStateIssuer
01580923MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260501001465 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8921576547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
199924NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Care Associates, LLP Past Accepting new patients
New York Hotel Trades Council & Hotel Association of Nyc Health Center Past Accepting new patients

Organizations & group practices 2

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548477466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68-80 SCHERMERHORN STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "718-858-7200",
            "fax_number": "718-858-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DENISE CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125802",
            "telephone_number": "718-605-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILOSOV",
        "first_name": "YAKHIYEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "199924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01580923",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.