Active NPI
John Andrew Iliya, M.D.
- Surgery Physician
- Rock Springs, WY
National Provider Identifier
1972606754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 3818A
- Practice address
- 313 Jade St
Rock Springs, WY 82901-6758 - Phone
- (307) 389-0059
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 3818A | WY | Primary |
Addresses
Primary practice location
313 Jade St
Rock Springs, WY 82901-6758
Mailing address
313 Jade St
Rock Springs, WY 82901-6758
Phone (307) 389-0059
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100123000262 | WY | Practitioner - General Surgery | 8426190851 | Practice locations: Rock Springs, WY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1972606754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 JADE ST",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "829016758",
"telephone_number": "307-389-0059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 JADE ST",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "829016758",
"telephone_number": "307-389-0059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILIYA",
"first_name": "JOHN",
"middle_name": "ANDREW",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WY",
"license": "3818A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Springs, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.