NPIMap

Individual provider Active NPI

Lori Marie De la Portilla, DO

  • Endocrinology, Diabetes & Metabolism Physician
  • Southington, CT
National Provider Identifier
1134562911
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
63628 Issued in CT
Practice address
462 Queen St # 303
Southington, CT 06489-1801
Phone
(305) 281-6686
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 63628 CT Primary

Addresses

Primary practice location

462 Queen St # 303
Southington, CT 06489-1801

Mailing address

462 Queen St
Ste 303
Southington, CT 06489-1801

Other practice location 1

Uconn Health Ctr
263 Farmington Avenue
Farmington, CT 06030-1235
Phone (860) 679-4613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190726001776 CT Practitioner - Endocrinology 4486975919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

462 Queen St
Suite 303
Southington, CT 06489-1801
Phone (860) 224-5672

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
63628CTMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 16, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jul 15, 2019 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Endocrinology, Diabetes & Metabolism CurrentSince Sep 16, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Endocrinology, Diabetes & Metabolism CurrentSince Jul 15, 2019 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

462 Queen St
Ste 303
Southington, CT 06489
Phone (860) 224-5672

462 Queen St
#303
Southington, CT 06489
Phone (305) 281-6686

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: lori.delaportilla@xdr.hhchealthdirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1134562911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 QUEEN ST",
            "address_2": "STE 303",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 QUEEN ST # 303",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891801",
            "telephone_number": "305-281-6686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Uconn Health Ctr",
            "address_2": "263 Farmington Avenue",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060301235",
            "country_code": "US",
            "telephone_number": "860-679-4613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA PORTILLA",
        "first_name": "LORI",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "63628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

Verify at the official NPI Registry.