Dominika J Portillo, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00863800 Issued in NJ

Practice address

2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552

Phone

(732) 766-8945

NPI assigned

Mar 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Link Home Services of NJ LLCGroup PAC ID 9133551765, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Link Home Services of NJ LLC

  • Physical Therapy Clinic/Center
  • Englewood Cliffs, NJ
  • NPI 1972072585
  Medicare reassignment Care Compare group NPD
• Coastal Urology Associates PA

  • Urology Physician
  • Brick, NJ
  • NPI 1215910286
  NPD (past)

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1013476688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LISA ROBYN CIR APT 101",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087017018",
            "telephone_number": "732-766-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 OCEAN AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294552",
            "telephone_number": "732-766-8945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 Marter Ave",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573114",
            "country_code": "US",
            "telephone_number": "856-291-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "DOMINIKA",
        "middle_name": "J",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00863800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shakera Porter
• Sophia Porter, RN
• Tamara Porter, RN
• Yvette Porter
• Kathryn Portera
• Rimma Portman, D.D.S.
• Asya Portnaya, CM
• Lika Portnaya, OTR/L
• Shawn K Portner, LCSW
• Darin A Portnoy, MD

• Occupational Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.