Active NPI
Sage Ilas, FNP
- Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1700606282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 315482
- Practice address
- 5355 E High St Unit 101
Phoenix, AZ 85054-5481 - Phone
- (928) 978-0198
- NPI assigned
- Oct 10, 2024
- Last updated
- Oct 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 315482 | AZ | Primary |
Addresses
Primary practice location
5355 E High St Unit 101
Phoenix, AZ 85054-5481
Mailing address
5223 E Herrera Dr
Phoenix, AZ 85054-7183
Phone (928) 978-0198
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 315482 | AZ | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728691200000",
"number": "1700606282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5223 E HERRERA DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850547183",
"telephone_number": "928-978-0198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5355 E HIGH ST UNIT 101",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850545481",
"telephone_number": "928-978-0198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILAS",
"first_name": "SAGE",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-10",
"last_updated": "2024-10-12",
"certification_date": "2024-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "315482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.