Active NPI
Mila Ioussifova, OD, CNS, FAAO
- Optometrist
- Portland, OR
National Provider Identifier
1821282609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ATI3296
- Practice address
- 3615 SW River Pkwy
Portland, OR 97239-4552 - Phone
- (971) 229-0820
- Fax
- (971) 229-0821
- NPI assigned
- Sep 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3296AT | OR | |
| Optometrist | 152W00000X | ATI3296 | OR | Primary |
Addresses
Primary practice location
3615 SW River Pkwy
Portland, OR 97239-4552
Mailing address
3615 SW River Pkwy
Portland, OR 97239-4552
Phone (971) 229-0820
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3615 S River Pkwy
Portland, OR 97239-4552
Phone (971) 229-0820
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ATI3296 | OR | MD | Optometrist |
Organizations & group practices 1
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.
-
- Optometrist
- Portland, OR
- NPI 1447602818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1821282609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3615 SW RIVER PKWY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394552",
"telephone_number": "971-229-0820",
"fax_number": "971-229-0821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 SW RIVER PKWY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394552",
"telephone_number": "971-229-0820",
"fax_number": "971-229-0821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IOUSSIFOVA",
"first_name": "MILA",
"credential": "OD, CNS, FAAO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-05",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "3296AT",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "ATI3296",
"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 Oct 22, 2024; 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.