Dr Andrey Alexandrovich Ilyasov, MD is a medicare enrolled "Hospitalist" physician in Liberal, Kansas. His current practice location is
315 W 15th St, Liberal, Kansas. You can reach out to his office (for appointments etc.) via phone at
(620) 629-6477.
Dr Andrey Alexandrovich Ilyasov is licensed to practice in Kansas (license number 04-37011) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1972575587.
Physician's Profile
| Full Name | Dr Andrey Alexandrovich Ilyasov |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 315 W 15th St, Liberal, Kansas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Andrey Alexandrovich Ilyasov attended and graduated from in
NPI Data:
- NPI Number: 1972575587
- Provider Enumeration Date: 02/07/2006
- Last Update Date: 03/08/2017
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Andrey Alexandrovich Ilyasov such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1972575587 | NPI | - | NPPES |
| P00435714 | Other | NC | RAILROAD MEDICARE |
| 5902572 | Medicaid | NC | |
| 200554510A | Medicaid | OK | |
| 201122270A | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 34051 (South Carolina) | Secondary |
| 207R00000X | Internal Medicine | 200501714 (North Carolina) | Secondary |
| 208M00000X | Hospitalist | 04-37011 (Kansas) | Primary |
| 208M00000X | Hospitalist | 35106 (Alabama) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Andrey Alexandrovich Ilyasov is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Andrey Alexandrovich Ilyasov, MD
Po Box 1215, Attn Clinic Billing Office,
Liberal, KS 67905-1215
Ph: (620) 629-6638 | Dr Andrey Alexandrovich Ilyasov, MD
315 W 15th St,
Liberal, KS 67901-2455
Ph: (620) 629-6477 |
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