Individual provider Active NPI

Melissa Rose Ihly

  • Social Worker
  • Portland, OR
National Provider Identifier
1558025700
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
7916 SE Foster Rd Ste 201
Portland, OR 97206-4289
Phone
(503) 465-2749
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X
Social Worker 104100000X Primary

Addresses

Primary practice location

7916 SE Foster Rd Ste 201
Portland, OR 97206-4289

Mailing address

7916 SE Foster Rd Ste 201
Portland, OR 97206-4289

Other practice location 1

86 S 14th St
San Jose, CA 95112-2015
Phone (408) 510-7080

Other practice location 2

438 N White Rd
San Jose, CA 95127-1439
Phone (408) 254-6828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bridges to Change CurrentSince Sep 3, 2025 Accepting new patients
Bridges to Change PastSince Sep 3, 2025 Accepting new patients

Locations

7916 SE Foster Rd
Ste 201
Portland, OR 97206
Phone (503) 290-8850

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bridgestochange/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1558025700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7916 SE FOSTER RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 SE FOSTER RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064289",
            "telephone_number": "503-465-2749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 S 14th St",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951122015",
            "country_code": "US",
            "telephone_number": "408-510-7080",
            "fax_number": "408-510-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "438 N White Rd",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951271439",
            "country_code": "US",
            "telephone_number": "408-254-6828",
            "fax_number": "408-642-6052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IHLY",
        "first_name": "MELISSA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.