Individual provider Active NPI

Benedikt Ilyaguyev

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1679070932
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
309818-01 Issued in NY
Practice address
One Gustave L. Levy Place
Floor 12, 1620
New York, NY 10029
Phone
(847) 338-6323
NPI assigned
Apr 11, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 309818 NY
Emergency Medicine Physician 207P00000X 309818-01 NY Primary

Addresses

Primary practice location

One Gustave L. Levy Place
Floor 12, 1620
New York, NY 10029

Mailing address

3201 Kings Hwy
Brooklyn, NY 11234-2625
Phone (718) 571-2901

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210514001521 NY Practitioner - Emergency Medicine 8729325261 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3201 Kings Hwy
Brooklyn, NY 11234-2625
Phone (212) 987-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309818NYMDEmergency Medicine Physician
309818-01NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Single Specialty CurrentSince Sep 1, 2023 Accepting new patients
Fpa Hospital Based Single Specialty Current Accepting new patients
Fpa Hospital Based Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Single Specialty CurrentSince Sep 1, 2023 Accepting new patients
North Shore-Lij Medical PC Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Fpa Hospital Based Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Single Specialty Current Accepting new patients

Locations

3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

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

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

Networks

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

Interoperability endpoints

  • Direct secure messaging: bilyaguyev65185@northwell.direct-ci.com

Organizations & group practices 8

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 3

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1679070932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342625",
            "telephone_number": "718-571-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE L. LEVY PLACE",
            "address_2": "FLOOR 12, 1620",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "847-338-6323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILYAGUYEV",
        "first_name": "BENEDIKT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "309818",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "309818-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.