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DR. ILYA YEGUDKIN DO
NPI 1750066593
Student in an Organized Health Care Education/Training Program in Las Vegas, NV

Active since June 20, 2023PECOS Enrolled
620 SHADOW LN, LAS VEGAS, NV 89106(702) 388-4000 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 21, 2025, Jun 20, 2023 (2 updates tracked since 2023).

About Dr. Ilya Yegudkin Do NPPES

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

DR. ILYA YEGUDKIN DO (NPI 1750066593) is an individual student in an organized health care education/training program in Las Vegas, Nevada, licensed in Nevada (SL2023) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS and is a graduate of Touro Un Col Of Osteopathic Medicine, Henderson (2023).

NPPES Registry Identity

NPI1750066593
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. ILYA YEGUDKINCredential: DO
Location Address620 SHADOW LNLas Vegas, NV 89106-4194
Mailing Address620 Shadow LnLas Vegas, NV 89106-4194 · (702) 388-4000
Phone(702) 388-4000
Sole ProprietorNo
Medical School CMSTouro Un Col Of Osteopathic Medicine, HendersonGraduated 2023
Enumeration DateJune 20, 2023
Last NPPES UpdateNovember 21, 20252 updates tracked since enumeration
NPPES CertifiedNovember 21, 2025
✔ NPI 1750066593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in NV · SL2023
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.
Also ListedGeneral PracticeTaxonomy 208D00000X · License DO3957 (NV)
620 SHADOW LN, Las Vegas, NV 89106
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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)

Dr. Ilya Yegudkin Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678929452
PECOS Enrollment IDI20260129001868
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.

JANN STACEY PICKENS NP
Nurse Practitioner
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4506
DR. VICTOR HOANG D.O.
Orthopaedic Surgery
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-8436
DR. KAY E MCMILLAN DO
Emergency Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4500
DR. FELIX ALEXIE DO
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000
ALEX HIRSCHFELD GOLDBACH MD
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 477-6572
NASIBO KADIR MD PLLC
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000
DR. JOHN YOUNG KO DO
Internal Medicine (Gastroenterology)
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-8436
DR. NICHOLAS CIURCZAK DO
Student in an Organized Health Care Education/Training Program
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000

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 Yegudkin's NPI number?

The NPI number for Ilya Yegudkin is 1750066593. It was assigned to this individual provider in the NPPES registry on June 20, 2023.

Where is Ilya Yegudkin located?

Ilya Yegudkin practices at 620 Shadow Ln, Las Vegas, NV 89106. The listed phone number is (702) 388-4000.

What is Ilya Yegudkin'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 Yegudkin enrolled in Medicare?

Yes. Ilya Yegudkin is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ilya Yegudkin was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.