Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mikhail Ilyasov, OTR/L

Individual provider Occupational Therapist · NPI 1780260018

Mikhail Ilyasov, OTR/L is an Occupational Therapist in Private Practice in Rego Park, New York. Qualified in 2020, 6 years ago. Practices with Occupational Therapy Nest PLLC, a 2-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2021
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

9508 Queens Blvd Ste 1E
Rego Park, NY 11374-1151
Phone: (718) 275-2669
Fax: (718) 275-2686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 025495 (NY)

Record details

NPI number1780260018
Entity typeIndividual (Type 1)
GenderMale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedMarch 18, 2021
Last updated in NPPESMarch 18, 2021
Certification dateMarch 18, 2021

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Occupational Therapy Nest Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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