MR. ILYA PAVLOV DO
NPI 1366139800
Student in an Organized Health Care Education/Training Program in Plantation, FL
About Mr. Ilya Pavlov Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. ILYA PAVLOV DO (NPI 1366139800) is an individual student in an organized health care education/training program in Plantation, Florida and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Hinsdale.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Ilya Pavlov Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Ilya Pavlov reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Plantation, FL 33324
- Reassigned Medicare billing, Florida enrollment
- 570 clinicians in this Medicare group
Miami Gardens, FL 33054
- Reassigned Medicare billing, Florida enrollment
- Medicare enrollment name: Public Health Trust Of Miami Dade County Florida
- 47 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
PLANTATION, FL 33324
PLANTATION, FL 33324
PLANTATION, FL 33324
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 Ilya Pavlov's NPI number?
The NPI number for Ilya Pavlov is 1366139800. It was assigned to this individual provider in the NPPES registry on April 24, 2023.
Where is Ilya Pavlov located?
Ilya Pavlov practices at 600 S Pine Island Rd, Plantation, FL 33324. The listed phone number is (305) 355-6060.
What is Ilya Pavlov's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Ilya Pavlov enrolled in Medicare?
Yes. Ilya Pavlov is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Ilya Pavlov's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ilya Pavlov reassigns Medicare benefits to 2 organizations: Public Health Trust Of Miami Dade County Florida (Plantation, FL) and Public Health Trust Of Miami Conty Florida (Miami Gardens, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ilya Pavlov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ilya Pavlov was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Mr. Ilya Pavlov, DO · NPI 1366139800
Student in an Organized Health Care Education/Training Program provider in Plantation, Florida. Individual provider, active in the CMS NPPES registry since April 24, 2023.
## Identity
- **NPI:** 1366139800 (Entity type: Individual)
- **Enumerated:** April 24, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 600 S PINE ISLAND RD, Plantation, FL 33324-3166
- **Phone:** (305) 355-6060
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Public Health Trust Of Miami Dade County Florida (NPI 1245121425, Plantation, FL); Public Health Trust Of Miami Conty Florida (NPI 1982146585, Miami Gardens, FL) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1366139800) · Data from the CMS NPPES public registry.