Ilan Semandov, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

251750 Issued in NY

Practice address

81 Skillman St
St
Brooklyn, NY 11205-2803

Phone

(718) 694-9000

Fax

(718) 237-9305

NPI assigned

Jul 24, 2009

Last updated

Feb 18, 2014By the provider in NPPES

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Suffolk Primary Health LLCGroup PAC ID 9436420510, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

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.

• Park Avenue Pediatrics, P.C.

  dba PArk Avenue Health CEnter

  • Pediatrics Physician
  • Spring Valley, NY
  • NPI 1699969543
  Medicare reassignment NPD
• Ilan Semandov DO PC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1457060170
  Authorized official Same address or phone
• Suffolk Primary Health, LLC

  • Primary Care Clinic/Center
  • Riverhead, NY
  • NPI 1174965727
  Care Compare group
• New York University

  dba NYU Langone Ambulatory Care Chelsea

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD (past)

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1669602520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 E 24TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292426",
            "telephone_number": "917-238-7234",
            "fax_number": "718-237-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 SKILLMAN ST",
            "address_2": "ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052803",
            "telephone_number": "718-694-9000",
            "fax_number": "718-237-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMANDOV",
        "first_name": "ILAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "251750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Selzer, D.D.S.
• Ryan Selzer, LCSW
• Suheil Semacaritts
• Sophie F Semah
• Elizabeth Seman, RN
• Una Semar, LMSW
• Olesya Semchenkova, O.D.
• Amanda Semel
• Rebecca Semel, PHD
• Robert A. Semel, PSY.D.

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.