Eitan Ilyayev, (PA)

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

017825 Issued in NY

Practice address

9819 64TH Ave Apt 4G
Rego Park, NY 11374-2526

Phone

(718) 483-2731

NPI assigned

Aug 6, 2014

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: eilyayev1938699@nychhc.direct-ci.com

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.

• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Queens Doctors

  • Internal Medicine Physician
  • Astoria, NY
  • NPI 1477932275
  Medicare reassignment NPD
• The Mount Sinai Hospital

  dba Mount Sinai Queens, Professional Billing

  • General Acute Care Hospital
  • Long Island City, NY
  • NPI 1013948595
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Mount Sinai Hospital

  • Community/Retail Pharmacy
  • Astoria, NY
  • NPI 1588408421
  NPD

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1609285329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9819 64TH AVE APT 4G",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742526",
            "telephone_number": "718-483-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9819 64TH AVE APT 4G",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742526",
            "telephone_number": "718-483-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYAYEV",
        "first_name": "EITAN",
        "credential": "(PA)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mazal Ilyaich
• Eduard Ilyasov
• Mikhail Ilyasov, OTR/L
• Svetlana Ilyasova
• Albert Ilyayev, D.D.S
• Emmanuil Ilyayev, DDS
• Daniela Ilyayeva, OTR/L
• Dora Ilyayeva
• Inessa Ilyayeva
• Julia A Ilyayeva

• Medical Physician Assistant in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.