NPIMap

Organization Active NPI

Ilya Badalov Physician PC

  • Colon & Rectal Surgery Physician
  • Flushing, NY
National Provider Identifier
1962655167
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
ILYA BADALOV PHYSICIAN PC
Practice address
13511 78TH Dr
Flushing, NY 11367-3235
Phone
(718) 847-9329
NPI assigned
Oct 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Ilya Badalov, MDNPI 1679543888
Title
President
Phone
(718) 847-9329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208C00000X Primary

Addresses

Primary practice location

13511 78TH Dr
Flushing, NY 11367-3235

Mailing address

13511 78TH Dr
Flushing, NY 11367-3235
Phone (718) 847-9329

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1962655167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13511 78TH DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673235",
            "telephone_number": "718-847-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13511 78TH DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673235",
            "telephone_number": "718-847-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILYA BADALOV PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "BADALOV",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-847-9329",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.