Luis Fernando Carrillo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200550017NP Issued in OR

Practice address

6538 N Kerby Ave
Portland, OR 97217-1939

Phone

(503) 283-8351

NPI assigned

May 27, 2005

Last updated

Apr 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Fernando Carrillo Professional name

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Multnomah County

  dba Multnomah County Health Dept, North Portland

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1609914787
  Medicare reassignment NPD
• Multnomah County

  dba Communicable Disease

  • Community Health Clinic/Center
  • Portland, OR
  • NPI 1639534969
  NPD
• Multnomah County

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1912322074
  NPD
• Central City Concern

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1881658276
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1083617658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6538 N KERBY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171939",
            "telephone_number": "503-283-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6538 N KERBY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171939",
            "telephone_number": "503-283-8351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 N Williams Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271885",
            "country_code": "US",
            "telephone_number": "503-238-2067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8225 NE Wasco St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972205784",
            "country_code": "US",
            "telephone_number": "971-361-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12121 E Burnside St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972163737",
            "country_code": "US",
            "telephone_number": "971-361-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 W Burnside St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972093514",
            "country_code": "US",
            "telephone_number": "503-228-4533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "LUIS",
        "middle_name": "FERNANDO",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200550017NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSBN WORKER'S COMP",
            "identifier": "ANP 397",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERNANDO",
            "last_name": "CARRILLO",
            "prefix": "DR.",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Susan Carrigg, PT
• Jose M Carrillo-Castro, MD
• Adrian Carrillo
• Aesha Marie Carrillo, DC
• Brenda Carrillo
• Alejandro Ricardo Carrion, DMD
• Allison Rebecca Carroll, M.D.
• Amy Carroll, ATC, MA
• Autumn Jessica Carroll, OTR/L
• Brendan Cargill Carroll, MD

• Family Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.