Individual provider Active NPI

Marlo L. McIlraith, MD

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1407861909
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD22169 Issued in OR
Practice address
15220 NW Laidlaw Rd Ste 100
Portland, OR 97229-7717
Phone
(503) 418-2000
NPI assigned
Jul 31, 2006
Last updated
Dec 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD22169 OR Primary

Addresses

Primary practice location

15220 NW Laidlaw Rd Ste 100
Portland, OR 97229-7717

Mailing address

15220 NW Laidlaw Rd
Portland, OR 97229-7716
Phone (503) 418-2415

Other identifiers 1

IdentifierTypeStateIssuer
134289MedicaidOR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081205000205 OR Practitioner - Pediatric Medicine 4587725825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of California, San Diego School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15220 NW Laidlaw Rd
Portland, OR 97229-7717
Phone (503) 418-2000

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services Pediatrics Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

15220 NW Laidlaw Rd
Ste 100
Portland, OR 97229
Phone (503) 418-2000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: mmcilraithmd14666@direct.ohsu.edu

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1407861909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15220 NW LAIDLAW RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297716",
            "telephone_number": "503-418-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15220 NW LAIDLAW RD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297717",
            "telephone_number": "503-418-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILRAITH",
        "first_name": "MARLO",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD22169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134289",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.