Sandra Iloka, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD186383 Issued in OR

Practice address

15640 NW Laidlaw Rd Ste 102
Portland, OR 97229-3828

Phone

(503) 764-0100

Fax

(503) 536-4260

NPI assigned

Mar 26, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Cincinnati College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Home Health Home health agency, Portland, OR, CCN 387048
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: siloka963569@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Family Medicine Physician
  • Hillsboro, OR
  • NPI 1003916354
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Family Medicine Physician
  • Gresham, OR
  • NPI 1053419218
  NPD
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • Clinical Pathology Physician
  • Newberg, OR
  • NPI 1174074868

  Family Medicine

  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Family Medicine Physician
  • Portland, OR
  • NPI 1790880805
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Internal Medicine Physician
  • Sherwood, OR
  • NPI 1184729329

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services Oregon

  dba Providence Home Health

  • Home Health Agency
  • Portland, OR
  • NPI 1790873461
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1114311222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15640 NW LAIDLAW RD STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972293828",
            "telephone_number": "503-764-0100",
            "fax_number": "503-536-4260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16770 SW Edy Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Sherwood",
            "state": "OR",
            "postal_code": "971409679",
            "country_code": "US",
            "telephone_number": "503-216-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILOKA",
        "first_name": "SANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD186383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "siloka963569@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "16770 SW Edy Rd Ste 102",
            "city": "Sherwood",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971409679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Illuminate and Liberate Counseling, LLC
• Illuminate Healing LLC
• Illumination Counseling LLC
• Illumination Rock Integrative Medicine, LLC
• Marissa Ilnitzki
• Kelly Ann Ilseman, MACOM, MS, MED
• Justin Yohalem Ilsley, ND
• Jin Seon Im, M.D.
• Soobin Im
• Imagine If Psychotherapy LLC

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.