NPIMap

Individual provider Active NPI

Ilya Domnich, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1699793034
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
217873 Issued in NY
Practice address
1687 Ralph Ave
Brooklyn, NY 11236-3319
Phone
(917) 318-5726
Fax
(718) 209-1891
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 217873 NY Primary

Addresses

Primary practice location

1687 Ralph Ave
Brooklyn, NY 11236-3319

Mailing address

1687 Ralph Ave
Brooklyn, NY 11236-3319
Phone (913) 318-5726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041130000650 NY Practitioner - Internal Medicine 6204891310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allied Medical Associates PCGroup PAC ID 3779670856, 2 clinicians
Affinity Medical PCGroup PAC ID 9739348095, 2 clinicians

Practice addresses (Care Compare)

1687 Ralph Ave
Brooklyn, NY 11236-3319
Phone (718) 251-7191

8635 21St Ave
Suite 1a
Brooklyn, NY 11214-4033
Phone (718) 758-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.77 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217873NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Medical Associates, P.C. Internal Medicine CurrentSince Sep 1, 2007 Accepting new patients
Shore View Acquisition I, LLC Past Accepting new patients

Locations

1687 Ralph Ave
Brooklyn, NY 11236
Phone (718) 251-7191

8635 21st Ave
Ste 1A
Brooklyn, NY 11214
Phone (718) 265-2424

Networks

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

Organizations & group practices 3

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1699793034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363319",
            "telephone_number": "913-318-5726",
            "fax_number": "718-209-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363319",
            "telephone_number": "917-318-5726",
            "fax_number": "718-209-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMNICH",
        "first_name": "ILYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "217873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.