Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dr. Ilya Ivanov, DO

Individual provider Psychiatry Physician · NPI 1487848149

Dr. Ilya Ivanov, DO practises Psychiatry in Mount Laurel, New Jersey. Graduated from Rowan University School of Osteopathic Medicine in 2005, 21 years ago. Practices with Virtua Medical Group, PA, a 1,669-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
21
Trained at
Rowan University School of Osteopathic Medicine
Licensed in
NJ
In the registry since
2007
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

100 Century Pkwy Ste 350
Mount Laurel, NJ 08054-1149
Phone: (856) 482-9000
Fax: (856) 482-1159
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 025MB8329500 (NJ)

Record details

NPI number1487848149
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedSeptember 5, 2007
Last updated in NPPESMarch 14, 2024
Certification dateMarch 14, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolROWAN UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2005 (21 years in practice)
Group practice Virtua Medical Group, Pa — 1669 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients59
Services billed 325 a service is one billed item, such as a visit, a test or a procedure
Average patient age53

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Jefferson Stratford Hospital Hospital · Stratford, NJ

Colleagues at Virtua Medical Group, PA

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1669 clinicians in the practice; 12 are shown here.

Other providers in Mount Laurel