Joanna Stephanie Portillo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R233531 Issued in MD

Practice address

9 Saint Paul St Ste 3
Boonsboro, MD 21713-1334

Phone

(301) 432-6897

NPI assigned

May 16, 2024

Last updated

Jul 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MD

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

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Frederick Health Medical Group LLCGroup PAC ID 9931341096, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Frederick Health Medical Group LLC

  dba Frederick Health Medical Group

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1619258225
  Medicare reassignment Care Compare group NPD (past)
• South Mountain Community Health LLC

  • Family Nurse Practitioner
  • Boonsboro, MD
  • NPI 1932388493
  Medicare reassignment NPD
• Frederick Health Medical Group LLC

  • Family Medicine Physician
  • Mount Airy, MD
  • NPI 1114771862
  NPD
• Frederick Health Medical Group LLC

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1578362836
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  Care Compare affiliation

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1184473696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SAINT PAUL ST STE 3",
            "city": "BOONSBORO",
            "state": "MD",
            "postal_code": "217131334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SAINT PAUL ST STE 3",
            "city": "BOONSBORO",
            "state": "MD",
            "postal_code": "217131334",
            "telephone_number": "301-432-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "JOANNA",
        "middle_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R233531",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MD",
            "license": "R233531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Phillips, LCSW-C
• Jennifer Lee Plantz
• Pleasant Valley Primary Care
• Podiatry Associates PA
• Morgan Pomfrey, PHARMD
• Privia Medical Group, LLC
• Elizabeth Kesecker Proctor
• Meghan Redding
• Reeders (Reeders Memorial Home, Inc.)
• Reeders Facility Operations, LLC (Reeders Memorial Home)

• Family Nurse Practitioner in Boonsboro, MD
• Providers in Boonsboro, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.