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ILONA DOBROWOLSKA SAMARA MD
NPI 1235271719
Family Medicine in Mustang, OK

Active since February 13, 2007Opted out of Medicare · through Apr 1, 2027
201 S SARA RD, SUITE 200, MUSTANG, OK 73064(405) 578-3250(405) 578-3299 Get Directions Write a Review

NPPES record last updated: April 27, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ilona Dobrowolska Samara Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ILONA DOBROWOLSKA SAMARA MD (NPI 1235271719) is an individual family medicine provider in Mustang, Oklahoma, licensed in Oklahoma (24606) and active in the NPI registry since February 2007. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1235271719
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameILONA DOBROWOLSKA SAMARACredential: MD
Location Address201 S SARA RD, SUITE 200Mustang, OK 73064-4303
Mailing Address201 S Sara Rd, Suite 200Mustang, OK 73064-4303 · (405) 578-3250 · Fax (405) 578-3299
Phone(405) 578-3250
Fax(405) 578-3299
Sole ProprietorNo
Enumeration DateFebruary 13, 2007
Last NPPES UpdateApril 27, 2015
✔ NPI 1235271719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OK · 24606
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
201 S SARA RD, Mustang, OK 73064
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Ilona Dobrowolska Samara Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2017 through April 1, 2027.

Opt-Out Effective DateApril 1, 2017
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73064 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$201.43 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MACKENZIE DENNIS N.P.
Nurse Practitioner (Family)
201 S SARA RD
MUSTANG, OK 73064
Canadian County (405) 272-9355
BRITTANY S DANIELS MD
Pediatrics
201 S SARA RD, SUITE 200
MUSTANG, OK 73064
Canadian County (405) 578-3250

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ilona Samara's NPI number?

The NPI number for Ilona Samara is 1235271719. It was assigned to this individual provider in the NPPES registry on February 13, 2007.

Where is Ilona Samara located?

Ilona Samara practices at 201 S Sara Rd Suite 200, Mustang, OK 73064. The listed phone number is (405) 578-3250.

What is Ilona Samara's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ilona Samara enrolled in Medicare?

No. Ilona Samara has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Ilona Samara accept?

Health plans from Medica list Ilona Samara as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ilona Samara was last updated on April 27, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.