Individual provider Active NPI

Ilana Khononov

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1992447635
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
404067 Issued in NY
Practice address
135 W 50TH St FL 6
New York, NY 10020-1201
Phone
(212) 582-9100
Fax
(212) 956-0526
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 404067 NY Primary

Addresses

Primary practice location

135 W 50TH St FL 6
New York, NY 10020-1201

Mailing address

1735 York Ave Apt 29E
New York, NY 10128-6861

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220616003016 NY Practitioner - Nurse Practitioner 7113306465 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Hudson GuildGroup PAC ID 0345139887, 4 clinicians

Practice addresses (Care Compare)

441 W 26TH St
New York, NY 10001-5629
Phone (212) 760-9822

Merit-based Incentive Payment System (MIPS)

Final score
87.65 of 100Reported as group
Quality
71.56
Promoting interoperability
74
Improvement activities
40
Cost
87.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
404067NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family and Children'S Services, Inc. Multi-Specialty CurrentSince Apr 1, 2022 Accepting new patients
Park East NP in Psychiatry Current Accepting new patients
Park East NP in Psychiatry Psychiatric/Mental Health CurrentSince Dec 24, 2023 Accepting new patients
Hasc Diagnostic &Treatment Center, Inc Multi-Specialty Current Accepting new patients
Jewish Board of Family & Childrens Services Inc Multi-Specialty CurrentSince Apr 1, 2022 Accepting new patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Jan 30, 2025 Accepting new patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Jan 30, 2025 Accepting new patients
Hudson Guild Multi-Specialty CurrentSince Mar 18, 2024 Accepting new patients

Locations

5601 1st Ave
Brooklyn, NY 11220
Phone (718) 650-0110

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

1221 E 14th St
Brooklyn, NY 11230
Phone (718) 434-4600

441 W 26th St
New York, NY 10001
Phone (212) 760-9800

5030 Broadway
Ste 201
New York, NY 10034
Phone (212) 632-4749

135 W 50th St
Fl 6
New York, NY 10020
Phone (212) 632-4700

9777 Queens Blvd
Rego Park, NY 11374
Phone (718) 275-9300

Networks

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

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1992447635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 YORK AVE APT 29E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101286861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W 50TH ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201201",
            "telephone_number": "212-582-9100",
            "fax_number": "212-956-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHONONOV",
        "first_name": "ILANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.