Individual provider Active NPI

Asad Ilyas, MS4

  • Student in an Organized Health Care Education/Training Program
  • Great River, NY
National Provider Identifier
1619889110
Registry record updated Sep 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3500 Sunrise Hwy Ste 300
Great River, NY 11739-1001
Phone
(631) 665-8500
NPI assigned
Sep 19, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3500 Sunrise Hwy Ste 300
Great River, NY 11739-1001

Mailing address

1671 E 17TH St Apt 1H
Brooklyn, NY 11229-1251
Phone (347) 722-2318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789776000000",
    "number": "1619889110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 E 17TH ST APT 1H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291251",
            "telephone_number": "347-722-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SUNRISE HWY STE 300",
            "city": "GREAT RIVER",
            "state": "NY",
            "postal_code": "117391001",
            "telephone_number": "631-665-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYAS",
        "first_name": "ASAD",
        "credential": "MS4",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-19",
        "last_updated": "2026-09-19",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.