Individual provider Active NPI

Damian Portela, M.D.

  • Urology Physician
  • Wellington, FL
National Provider Identifier
1194703330
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME94172 Issued in FL
Practice address
3347 State Road 7
Suite 101
Wellington, FL 33449-8095
Phone
(561) 790-2111
Fax
(561) 296-0436
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME94172 FL Primary

Addresses

Primary practice location

3347 State Road 7
Suite 101
Wellington, FL 33449-8095

Mailing address

2234 Colonial Blvd
Attn: Payer Contracting & Relations Dept.
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 8

IdentifierTypeStateIssuer
1062405OtherFLCAREPLUS
7451633OtherFLAETNA
11147OtherFLDIMENSION HEALTH
P01250OtherFLFREEDOM
P929225OtherFLOPTIMUM
32647OtherFLBCBS
1242202OtherFLWELLCARE
P01596411OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051115000888 FL Practitioner - Urology 7416913454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Practice addresses (Care Compare)

10141 Forest Hill Blvd
Wellington, FL 33414-6103
Phone (561) 753-2646

1419 SE 8TH Ter
Cape Coral, FL 33990-3213
Phone (239) 772-3202

1620 S Congress Ave
Suite 202
Palm Springs, FL 33461-2128
Phone (561) 790-2111

3347 S State Rd
7 Suite 101
Wellington, FL 33449-8148
Phone (561) 790-2111

730 Goodlette Rd
Suite 201
Naples, FL 34102-5618
Phone (239) 263-4499

Hospital & facility affiliations

  • Wellington Regional Medical Center Hospital, Wellington, FL, CCN 100275
  • HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC Urology Current Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Jan 18, 2016 Accepting new patients
Genesiscare USA of Florida LLC Urology Current Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Jan 18, 2016 Accepting new patients
Genesiscare USA of Florida LLC Urology Past Accepting new patients

Locations

1100 S Main St
Belle Glade, FL 33430
Phone (561) 996-4242

8198 S Jog Rd
Ste 209
Boynton Beach, FL 33472
Phone (561) 790-2111

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

2160 Colonial Blvd
Fort Myers, FL 33907

2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212

431 University Blvd
Jupiter, FL 33458
Phone (561) 296-9147

2141 S Highway A1A Alt
Ste 420
Jupiter, FL 33477
Phone (561) 743-5580

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

1620 S Congress Ave
Ste 202
Palm Springs, FL 33461
Phone (561) 790-2111

3343 S State Road 7
Wellington, FL 33449
Phone (561) 795-8945

3347 S State Road 7
Ste 101
Wellington, FL 33449
Phone (561) 790-2111

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: damienportela@palmbeach.medalliesdirect.net

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 2

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1194703330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS DEPT.",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3347 STATE ROAD 7",
            "address_2": "SUITE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498095",
            "telephone_number": "561-790-2111",
            "fax_number": "561-296-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTELA",
        "first_name": "DAMIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME94172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS",
            "identifier": "1062405",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7451633",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSION HEALTH",
            "identifier": "11147",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM",
            "identifier": "P01250",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P929225",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32647",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1242202",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01596411",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.