Andrey A Ilyasov (NPI# 1972575587, PAC ID# 3971525809) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1972575587 |
| PAC ID by PECOS | 3971525809 |
| Professional Enrollment ID | I20140517000152 |
| Full Name | Andrey A Ilyasov |
| Organization Legal Name | CANCER CENTER OF KANSAS.P.A. |
| Address |
315 W 15th St Liberal KS 67901-2455 |
| Phone Number | 6206296727 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1987 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | HOSPITALIST |
| Group Practice PAC ID | 5395732820 |
| Number of Group Practice Members | 76 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 170068 | SOUTHWEST MEDICAL CENTER |
| 010012 | DEKALB REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 200 Medical Ctr Dr Sw, Fort Payne, AL 35968-3458 | 2568453150 | PHYSYNERGY MEDICAL SERVICES LLC |
| 1 Hospital Dr Sw, Huntsville, AL 35801-6455 | 2568823100 | PHYSYNERGY MEDICAL SERVICES LLC |
| 315 W 15th St, Liberal, KS 67901-2455 | 6206296727 | CANCER CENTER OF KANSAS.P.A. |
| 555 W 15th St, Liberal, KS 67901-2467 | 6206245666 | SOUTHWEST MEDICAL CENTER |
| Organization Legal Name | CANCER CENTER OF KANSAS.P.A. |
| Physicians | 54 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julie Crotts | Nurse Practitioner | Cancer Center of Kansas.p.a. | 116 W Ross Blvd, Dodge City, KS 67801-2131 |
| Joshua A Reed | Nurse Practitioner | Cancer Center of Kansas.p.a. | 750 Ave D W, Kingman, KS 67068-1266 |
| Phu V Truong | Hematology/oncology | Cancer Center of Kansas.p.a. | 505 S Plummer, Chanute, KS 66720-1950 |
| Imad I Nassif | Gastroenterology | Cancer Center of Kansas.p.a. | 3243 E Murdock, Wichita, KS 67208-3006 |
| Bassam I Mattar | Hematology/oncology | Cancer Center of Kansas.p.a. | 1305 W, 5th, Winfield, KS 67156-2406 |
| Dennis F Moore Jr. | Hematology/oncology | Cancer Center of Kansas.p.a. | 700 W Central, El Dorado, KS 67042-2184 |
| Dwight E Wheeler | Internal Medicine | Cancer Center of Kansas.p.a. | 818 N Emporis, Suite 403, Wichita, KS 67214-3728 |
| Jose F Gutierrez | Certified Registered Nurse Anesthetist (crna) | Cancer Center of Kansas.p.a. | 9050 E 29th St N, Suite 100, Wichita, KS 67226-2187 |
| Lacie L Gregory | Family Medicine | Cancer Center of Kansas.p.a. | 818 N Emporia St, Suite 403, Wichita, KS 67214-3728 |
| Kimberly D Widler | Nurse Practitioner | Cancer Center of Kansas.p.a. | 750 Ave D W, Kingman, KS 67068-1266 |
| Street Address |
315 W 15TH ST |
| City | LIBERAL |
| State | KS |
| Zip | 67901-2455 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert A Williams | Diagnostic Radiology | 315 W 15th St, Liberal, KS 67901-2455 | |
| Bruce Wayne Cook | Certified Registered Nurse Anesthetist (crna) | Southwest Medical Center | 315 W 15th St, Southwest Medical Center Anesthesia, Liberal, KS 67901-2455 |
| Lori E Failes | Emergency Medicine | Rural Kansas Emergency Physicians LLC | 315 W 15th St, Liberal, KS 67901-2455 |
| Akshath Bantwal Kamath | Internal Medicine | Cancer Center of Kansas.p.a. | 315 W 15th St, Liberal, KS 67901-2455 |
| John C Peeden | Certified Registered Nurse Anesthetist (crna) | Southwest Medical Center | 315 W 15th St, Southwest Medical Center Anesthesia, Liberal, KS 67901-2455 |
| Rama Krishna Reddy Chanda | Hospitalist | Cancer Center of Kansas.p.a. | 315 W 15th St, Liberal, KS 67901-2455 |
| Robert W King | Emergency Medicine | Rural Kansas Emergency Physicians LLC | 315 W 15th St, Liberal, KS 67901-2455 |
| Jack L Morgan Jr. | Internal Medicine | Rural Kansas Emergency Physicians LLC | 315 W 15th St, Liberal, KS 67901-2455 |
| Edwin T. Mcgroarty | Family Medicine | Rural Kansas Emergency Physicians LLC | 315 W 15th St, Liberal, KS 67901-2455 |
| Assodallah Zainali | Diagnostic Radiology | 315 W 15th St, Liberal, KS 67901-2455 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Suhail A Ansari | Orthopedic Surgery | 2138 N Kansas Ave, Liberal, KS 67901-2012 | |
| Steven Douglas Graham | Optometry | Vision Source of Liberal Inc | 2136 N Kansas Ave, Liberal Kansas, KS 67901-2012 |
| Rhiannon Radcliff | Optometry | Vision Source of Liberal Inc | 2136 N Kansas Ave, Liberal Kansas, KS 67901-2012 |
| Elizabeth Ann Fieser | Optometry | Jury, Farrar and Associates, Doctors of Optometry, Pa | 2381 N Kansas Ave, Liberal, KS 67901-2055 |
| James S Jury | Optometry | Jury, Farrar and Associates, Doctors of Optometry, Pa | 2381 N Kansas Ave, Liberal, KS 67901-2055 |
| Ryan R Farrar | Optometry | Jury, Farrar and Associates, Doctors of Optometry, Pa | 2381 N Kansas Ave, Liberal, KS 67901-2055 |
| Molly Rachow | Physical Therapy | 111 Lilac Dr, Liberal, KS 67901-2058 | |
| Brandi L Boller | Family Medicine | 11 W Pkwy Blvd, Liberal, KS 67901-2081 | |
| Michael J Fulton | Optometry | 250 E Tucker Rd, Suite B, Liberal, KS 67901-2188 | |
| Varinder S Gill | Internal Medicine | 111 E Tucker Rd, Suite F, Liberal, KS 67901-2191 | |
| Find all physicians in zip 67901 | |||
| City | LIBERAL |
| Zip Code | 67901 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LIBERAL + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Andrey A Ilyasov.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.