Diana Portillo, DNP, FNP-C, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP-01613 Issued in NM

Practice address

330 N Campo St
Las Cruces, NM 88001-3433

Phone

(575) 288-1336

Fax

(575) 222-4453

NPI assigned

Mar 24, 2010

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

Practice roles

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.

• Rydan Solutions Inc

  • Substance Abuse Rehabilitation Facility
  • Las Cruces, NM
  • NPI 1245904879
  NPD (past)
• Rydan Solutions Inc

  • Substance Abuse Rehabilitation Facility
  • Las Cruces, NM
  • NPI 1386139780
  NPD (past)
• Rydan Solutions Inc

  • Substance Abuse Rehabilitation Facility
  • Las Cruces, NM
  • NPI 1699530204
  NPD (past)
• Traa Group LLC

  • Clinical Social Worker
  • Las Cruces, NM
  • NPI 1508221938
  NPD (past)
• Weeks Healthcare Industry LLC

  • Clinical Social Worker
  • Las Cruces, NM
  • NPI 1740885342
  NPD (past)

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1194049841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1731",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880041731",
            "telephone_number": "575-288-1336",
            "fax_number": "575-222-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N CAMPO ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013433",
            "telephone_number": "575-288-1336",
            "fax_number": "575-222-4453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 N Alameda Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880052590",
            "country_code": "US",
            "telephone_number": "575-523-0111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 W Picacho Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880074732",
            "country_code": "US",
            "telephone_number": "575-652-3646",
            "fax_number": "575-680-2415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 N Motel Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880078159",
            "country_code": "US",
            "telephone_number": "575-526-3437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "CNP-01613",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP-01613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20636865",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NMA100470",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Leticia Portas del Real
• Alisha Nichole Porter
• Silas Matthew Porter, DMD
• Ana Maria Portillo
• Crystal Portillo, LMHC
• Dorothy M Portillo, FNP-C
• Kenia Denise Portillo
• Melissa Anne Portillo, RN
• Rafael Portillo
• Robert S Poston, MD

• Psychiatric/Mental Health Nurse Practitioner in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.