NPIMap

Individual provider Active NPI

Amir Jon Dhillo, DO

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1417699745
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO225506 Issued in OR
Practice address
1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone
(503) 413-7074
Fax
(503) 413-6892
NPI assigned
Apr 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DO225506 OR Primary

Addresses

Primary practice location

1200 NW 23Rd Ave
Portland, OR 97210-2906

Mailing address

PO Box 3777
Portland, OR 97208-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729003215 OR Practitioner - Internal Medicine 4789062431 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Emanuel Hospital and Health CenterGroup PAC ID 4587573639, 235 clinicians
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2800 N Vancouver Ave
Suite 230
Portland, OR 97227-1668
Phone (503) 413-4340

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO225506ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 25, 2025 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Jul 3, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Clinics LLC CurrentSince Jul 3, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 25, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 25, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 25, 2025 Accepting new patients

Locations

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1417699745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102906",
            "telephone_number": "503-413-7074",
            "fax_number": "503-413-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHILLO",
        "first_name": "AMIR",
        "middle_name": "JON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO225506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.