Individual provider Active NPI

Georgina Aguilar-Portillo, MD

  • Family Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1144804691
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A184608 Issued in CA
Practice address
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone
(951) 486-4000
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A184608 CA Primary

Addresses

Primary practice location

26520 Cactus Ave
Moreno Valley, CA 92555-3927

Mailing address

1441 Constitution Blvd
BLDG 400, Third Floor
Salinas, CA 93906-3100
Phone (831) 755-4123

Other practice location 1

1441 Constitution Blvd
Bldg 400, Third Floor
Salinas, CA 93906-3100
Phone (831) 755-4123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029001548 CA Practitioner - Family Practice 7113450255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Canyon Springs Medical Group IncGroup PAC ID 0446297634, 14 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-5610

Hospital & facility affiliations

  • Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A184608CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Springs Medical Group, Inc. Family Medicine CurrentSince Oct 3, 2024 Accepting new patients

Locations

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

Interoperability endpoints

  • Direct secure messaging: gaguilarportillo1220325@direct.llu.edu

Organizations & group practices 1

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 1

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1144804691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 CONSTITUTION BLVD",
            "address_2": "BLDG 400, THIRD FLOOR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939063100",
            "telephone_number": "831-755-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Constitution Blvd",
            "address_2": "Bldg 400, Third Floor",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939063100",
            "country_code": "US",
            "telephone_number": "831-755-4123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUILAR-PORTILLO",
        "first_name": "GEORGINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A184608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.