Casey Anne Portillo, P.A. - C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03803 Issued in TX

Practice address

1935 Medical District Dr
Pavillion 3Rd Floor
Dallas, TX 75235-7701

Phone

(214) 456-1798

NPI assigned

Apr 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Casey Anne Adams Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Specialists of America PLLCGroup PAC ID 5294255006, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npokharel226024@direct.sw.org
• Direct secure messaging: cportillo@dermmckinney.emadirect.md

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.

• Dermatology Specialists of America PLLC

  • Dermatology Physician
  • McKinney, TX
  • NPI 1841012168
  Medicare reassignment Care Compare group
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Waxahachie, TX
  • NPI 1598658015
  NPD

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1063739381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 MEMORIAL LN",
            "address_2": "#2022",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "PAVILLION 3RD FLOOR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "CASEY",
        "middle_name": "ANNE",
        "credential": "P.A. - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npokharel226024@direct.sw.org",
            "affiliation": "N",
            "address_1": "5236 W University Dr Ste 2200",
            "city": "McKinney",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750718113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "ADAMS",
            "middle_name": "ANNE",
            "credential": "P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Randy Porter, LMFT
• Scott A Porter, M.D.
• Warren Curt Porter
• Robyn Porterfield, PHD
• Armando Eulogio Portillo
• Francina Portley
• Arianna Sibila Portmann Baracco, MD
• Andrew Michael Portteus, MD MPH
• Theresa Ann Posani, C.N.S.
• Positive Progressions Counseling Services, PLLC

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.

Verify at the official NPI Registry.