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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

VIKTOR ILYASOV DO
NPI 1235922303
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since May 22, 2025PECOS Enrolled
261 MACK AVE, DETROIT, MI 48201(313) 745-1203 Get Directions Write a Review

NPPES record last updated: June 27, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Viktor Ilyasov Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIKTOR ILYASOV DO (NPI 1235922303) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235922303
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameVIKTOR ILYASOVCredential: DO
Location Address261 MACK AVEDetroit, MI 48201-2495
Mailing Address261 Mack AveDetroit, MI 48201-2495 · (313) 745-1203
Phone(313) 745-1203
Sole ProprietorNo
Enumeration DateMay 22, 2025
Last NPPES UpdateJune 27, 2026
NPPES CertifiedJune 27, 2026
✔ NPI 1235922303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
261 MACK AVE, Detroit, MI 48201
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Viktor Ilyasov Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HANNAH MCKEE-BOYES PT, DPT
Physical Therapist
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 966-8309
JANINE MARIE HEATH PT, ATP
Physical Therapist
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 966-8309
LAURIE ANN NORRIS PT,DPT,MTC
Physical Therapist
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 745-1100
MS. KRISTINE KAY SMITH MS, ATC
Specialist/Technologist (Athletic Trainer)
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 745-1160
KATIE JEAN MCSWEEN MAY PT, DPT
Physical Therapist
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 745-1055
MS. ANNA MARIE CAIRNS PT
Physical Therapist
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 745-1100
MS. ALANNA GIORDANO OT
Occupational Therapist
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 745-1100
HANNA RIBNER
Physical Therapist
261 MACK AVE
DETROIT, MI 48201
Wayne County (313) 745-9796

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Viktor Ilyasov's NPI number?

The NPI number for Viktor Ilyasov is 1235922303. It was assigned to this individual provider in the NPPES registry on May 22, 2025.

Where is Viktor Ilyasov located?

Viktor Ilyasov practices at 261 Mack Ave, Detroit, MI 48201. The listed phone number is (313) 745-1203.

What is Viktor Ilyasov's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Viktor Ilyasov enrolled in Medicare?

Yes. Viktor Ilyasov is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Viktor Ilyasov was last updated on June 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 46 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.