NPIMap

Individual provider Active NPI

John H Iljas, D.O.

  • Vascular Surgery Physician
  • Livonia, MI
National Provider Identifier
1669440079
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
5101013457 Issued in MI
Practice address
15370 Levan Road
Suite 1
Livonia, MI 48154-1903
Phone
(734) 462-8401
Fax
(734) 462-1410
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 5101013457 MI Primary

Addresses

Primary practice location

15370 Levan Road
Suite 1
Livonia, MI 48154-1903

Mailing address

15370 Levan Road
Suite 1
Livonia, MI 48154-1903
Phone (734) 462-8401

Other identifiers 1

IdentifierTypeStateIssuer
340755311MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071030000231 MI Practitioner - Vascular Surgery 0840387478 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Philadelphia College of Osteopathic Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vellore R Ramakrishnan M.D., P.C.Group PAC ID 3476682535, 3 clinicians

Practice addresses (Care Compare)

15370 Levan Rd
Suite 1
Livonia, MI 48154-1903
Phone (734) 462-8401

36616 Plymouth Rd
Livonia, MI 48150-1127
Phone (734) 462-8401

Hospital & facility affiliations

  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
  • Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024
  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
75.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal12
Leg revascularization (restoring blood flow)104
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access and Vascular Care Vascular Surgery CurrentSince Feb 1, 2014 Accepting new patients
Envision Medical Group PLLC CurrentSince Jul 1, 2019 Accepting new patients
Envision Medical Group PLLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

39475 Lewis Dr
Ste 200
Novi, MI 48377
Phone (248) 471-0675

10861 W 10 Mile Rd
Oak Park, MI 48237
Phone (248) 268-1135

12660 10 Mile Rd
South Lyon, MI 48178
Phone (248) 348-1131

Interoperability endpoints

  • Direct secure messaging: jiljas1132886@direct.hfhs.org
  • Direct secure messaging: jiljas45655@direct.trinity-health.org
  • Direct secure messaging: jiljas@direct.dmc.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1669440079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15370 LEVAN ROAD",
            "address_2": "SUITE 1",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541903",
            "telephone_number": "734-462-8401",
            "fax_number": "734-462-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15370 LEVAN ROAD",
            "address_2": "SUITE 1",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541903",
            "telephone_number": "734-462-8401",
            "fax_number": "734-462-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILJAS",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "5101013457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340755311",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.