Individual provider Active NPI

Ilya Litvak

  • Emergency Medicine Physician
  • Staten Island, NY
National Provider Identifier
1649667957
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS019157 Issued in PA
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-9000
NPI assigned
Apr 24, 2015
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 290986 NY
Emergency Medicine Physician 207P00000X OS019157 PA Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-5067

Other practice location 2

3369 Route 100
Macungie, PA 18062-9613
Phone (610) 402-8111

Other practice location 3

3369 Route 100
Macungie, PA 18062-9613
Phone (610) 402-8111

Other identifiers 1

IdentifierTypeStateIssuer
07811636MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ilitvak393200@direct.rochesterregional.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, PA, FL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20171024001838 NY Practitioner - Emergency Medicine 5698041333 Reassigns benefits to 10 organizations
I20190731001229 NJ Practitioner - Emergency Medicine 5698041333 Reassigns benefits to 2 organizations
I20220727004016 PA Practitioner - Emergency Medicine 5698041333 Reassigns benefits to 7 organizations
I20260626002549 FL Practitioner - Emergency Medicine 5698041333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Emergency Physician Associates of Pennsylvania PCGroup PAC ID 5597663252, 88 clinicians

Practice addresses (Care Compare)

1000 E Mountain Dr
Wilkes Barre, PA 18711-0001
Phone (570) 826-7850

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

334 Main St
Dickson City, PA 18519-1668
Phone (570) 476-3353

3369 State Route 100
LVH Hospitalist PGRM
Macungie, PA 18062-9613
Phone (610) 402-8111

3371 State Route 100
LVPG Orthopedics and Sports Medicine Macu
Macungie, PA 18062-9613
Phone (610) 402-8900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
290986NYMDEmergency Medicine Physician
OS019157PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Aug 1, 2022 Accepting new patients
United Medical Associates PC CurrentSince Oct 15, 2018 Accepting new patients
Physicians of University Hospital, PC CurrentSince Jul 1, 2018 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine Current Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Aug 1, 2022 Accepting new patients
Pennsylvania Physician Services, LLC Emergency Medicine CurrentSince Apr 15, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 3, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 3, 2025 Accepting new patients
Rochester General Hospital CurrentSince Jul 29, 2024 Accepting new patients
Newark Wayne Community Hospital CurrentSince Jul 29, 2024 Accepting new patients
Rochester General Hospital CurrentSince Jul 29, 2024 Accepting new patients
Gslpg, Inc CurrentSince Sep 1, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Physicians of University Hospital, PC CurrentSince Jul 1, 2018 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Lehigh Valley Physician Group Emergency Medicine Current Accepting new patients
The Unity Hospital of Rochester CurrentSince Jul 29, 2024 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Pennsylvania Physician Services, LLC Emergency Medicine CurrentSince Apr 15, 2023 Accepting new patients
Geisinger Clinic CurrentSince Jul 15, 2024 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Aug 1, 2022 Accepting new patients
Emergency Associates of Montclair LLC Emergency Medicine CurrentSince Jun 2, 2019 Accepting new patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
United Medical Associates, P.C. CurrentSince Oct 15, 2018 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Exigence Medical of Binghamton PLLC CurrentSince Sep 1, 2017 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Aug 1, 2022 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Newark Wayne Community Hospital Current Accepting new patients
Medical Services of Suffolk County PC Emergency Medicine CurrentSince Sep 24, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Aug 1, 2018 Accepting new patients
Geieinger Clinic CurrentSince Jul 15, 2024 Accepting new patients

Locations (25 of 42)

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

755 Memorial Pkwy
Ste 302
Phillipsburg, NJ 08865
Phone (908) 847-6722

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

66 W Gilbert St
Ste 200
Tinton Falls, NJ 07701
Phone (732) 212-0051

301 E Main St
Bldg 21117
Bay Shore, NY 11706
Phone (631) 968-3100

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

300 Community Dr
Manhasset, NY 11030

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2170

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

Organizations & group practices 38

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.

View all 38

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1649667957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213011",
            "country_code": "US",
            "telephone_number": "585-922-5067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3369 Route 100",
            "address_purpose": "LOCATION",
            "city": "Macungie",
            "state": "PA",
            "postal_code": "180629613",
            "country_code": "US",
            "telephone_number": "610-402-8111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3369 Route 100",
            "address_purpose": "LOCATION",
            "city": "Macungie",
            "state": "PA",
            "postal_code": "180629613",
            "country_code": "US",
            "telephone_number": "610-402-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITVAK",
        "first_name": "ILYA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "290986",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS019157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07811636",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ilitvak393200@direct.rochesterregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1425 Portland Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146213011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.