Stanislav V Ilyusha, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

VUT006443 Issued in NY

Practice address

1612 Sheepshead Bay Rd
Brooklyn, NY 11235-3803

Phone

(718) 934-1123

Fax

(718) 934-2366

NPI assigned

May 18, 2006

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

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vista on the Bay IncGroup PAC ID 7810360872, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vista on the Bay Inc

  • Optometrist
  • Brooklyn, NY
  • NPI 1942916051
  Medicare reassignment Care Compare group NPD
• Family Optometry P.C

  • Optometrist
  • Brooklyn, NY
  • NPI 1548513922
  Medicare reassignment NPD
• Starlight Optical, Inc

  • Corneal and Contact Management Optometrist
  • Brooklyn, NY
  • NPI 1225203649
  NPD (past) Authorized official

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1750334264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 SHEEPSHEAD BAY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353803",
            "telephone_number": "917-803-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 SHEEPSHEAD BAY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353803",
            "telephone_number": "718-934-1123",
            "fax_number": "718-934-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYUSHA",
        "first_name": "STANISLAV",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "VUT006443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02218697",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miriam None Ilyayev
• Rafael Il'Ich Ilyayev, MD
• Irina Ilyayeva, DDS
• Radmila Ilyayeva
• Dmitry Ilyevsky, M.D.
• Nataliya Ilyushchanka
• Im Primary Medical Care , PC
• Imad John Bakoss
• Uhunoma Edna Imade
• Imaduddin Hashmi MD PLLC

• Corneal and Contact Management Optometrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Corneal and Contact Management Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.