Ilya Vyacheslavovich Ryaboy, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

036.160233 Issued in IL

Practice address

8901 Rockville Pike
Walter Reed National Military Medical Center
Bethesda, MD 20889-2908

Phone

(301) 295-4500

NPI assigned

Feb 12, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, IL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional Cardiology

Education

Tulane University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
• Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Sentara Hospitals

  dba Sentara Nightingale

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Norfolk General Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Virginia Beach General Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1629038336
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Leigh Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  Care Compare affiliation

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1558752501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "address_2": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208892908",
            "telephone_number": "301-295-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Riverview Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235101065",
            "country_code": "US",
            "telephone_number": "757-252-9365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYABOY",
        "first_name": "ILYA",
        "middle_name": "VYACHESLAVOVICH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101261685",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101261685",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101261685",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036.160233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Rothenberg MD, Chartered
• Carlyn Marie Russell
• Shoshannah Russell, AU.D.
• David James Rusthoven, D.M.D.
• Christina Rutherford, MD
• Andrea Ryan
• Beth E Ryan, PA
• Christina Ann Ryan, DO
• Kerry Ryan, PA-C
• Jisun Ryu, L.AC

• Interventional Cardiology Physician in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Interventional Cardiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.