Individual provider Active NPI

Rafael Il'Ich Ilyayev, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1730373192
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
245643 Issued in NY
Practice address
499 Crown St
Brooklyn, NY 11213-5126
Phone
(347) 614-1717
NPI assigned
Aug 29, 2007
Last updated
Apr 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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 245643 NY Primary

Addresses

Primary practice location

499 Crown St
Brooklyn, NY 11213-5126

Mailing address

499 Crown St
Brooklyn, NY 11213-5126
Phone (347) 614-1717

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
I20070921000333 NY Practitioner - Emergency MedicinePractitioner - Internal Medicine 5294829206 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

499 Crown St
Brooklyn, NY 11213-5126
Phone (347) 614-1717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
27.04 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
90.12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Refua Shlema Medical PC Internal Medicine CurrentSince Feb 11, 2008 Accepting new patients
Interfaith Emergency Medicine, P.C. CurrentSince Jul 1, 2013 Accepting new patients
Exigence Medical of Binghamton PLLC CurrentSince Oct 1, 2016 Accepting new patients
New York Community Hospital of Brooklyn, Inc. Internal Medicine Past Accepting new patients

Locations

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

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

499 Crown St
Brooklyn, NY 11213
Phone (347) 614-1717

Networks

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

Organizations & group practices 4

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.

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1730373192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 CROWN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135126",
            "telephone_number": "347-614-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 CROWN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135126",
            "telephone_number": "347-614-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYAYEV",
        "first_name": "RAFAEL",
        "middle_name": "IL'ICH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.