Organization Active NPI

Atlantic Comprehensive Medical PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Rego Park, NY
National Provider Identifier
1619838703
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ATLANTIC COMPREHENSIVE MEDICAL PC
Practice address
9725 63Rd Dr FL 2
Rego Park, NY 11374-2229
Phone
(718) 275-2900
Fax
(718) 275-2944
NPI assigned
Nov 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Authorized official

Name
Stella IlyayevaNPI 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

9725 63Rd Dr FL 2
Rego Park, NY 11374-2229

Mailing address

9725 63Rd Dr FL 2
Rego Park, NY 11374-2229
Phone (718) 275-2900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260102000634 NY Part B Supplier - Clinic/Group Practice 8123514858 Receives reassigned benefits from 2 practitioners
Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory

Locations

9725 63rd Dr
Fl 2
Rego Park, NY 11374
Phone (718) 275-2900

9725 63rd Dr
Rego Park, NY 11374
Phone (718) 271-8185

Practitioners & affiliated clinicians

Practitioners 2

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": "1763510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1619838703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 63RD DR FL 2",
            "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 FL 2",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742229",
            "telephone_number": "718-275-2900",
            "fax_number": "718-275-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC COMPREHENSIVE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-19",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "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"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 11, 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.