Irina Ilyasov, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

013442 Issued in NY

Practice address

8686 Bay Pkwy
Ste M4
Brooklyn, NY 11214-5103

Phone

(718) 265-7700

Fax

(718) 265-7701

NPI assigned

Oct 30, 2009

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles (2 of 6)

Networks

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

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.

• Icahn School of Medicine at Mount Sinai

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1114358348

  NY

  Medicare reassignment
• Bogdan Pain Management Services P.C.

  • Ambulatory Surgical Clinic/Center
  • Brooklyn, NY
  • NPI 1568790053
  NPD (past)
• Icahn School of Medicine at Mount Sinai

  • Ophthalmology Physician
  • New York, NY
  • NPI 1437421252
  NPD (past)

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1881920502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 KEUNE CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041431",
            "telephone_number": "718-265-7700",
            "fax_number": "718-265-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8686 BAY PKWY",
            "address_2": "STE M4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145103",
            "telephone_number": "718-265-7700",
            "fax_number": "718-265-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYASOV",
        "first_name": "IRINA",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilyagu Medical PC
• Mark Ilyagu, MD
• Luba Ilyaich, BS, PHARMD, CGP
• Maya Ilyas, DO
• Saba Ilyas, DO
• Yekaterina Ilyasova, NP
• Aleksandr Ilyayev, M.D.
• Gabriel Ilyayev, PHARMD
• Miriam None Ilyayev
• Rafael Il'Ich Ilyayev, MD

• All providers in Brooklyn, NY
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.