Lucilia Goncalves Portela, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

39512 Issued in CA

Practice address

1809 National Ave
San Diego, CA 92113

Phone

(619) 515-2300

NPI assigned

Apr 25, 2007

Sex

Female

Sole proprietor

Yes

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 CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Family Health Centers of San Diego, Inc.

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
  • NPI 1326231713
  NPD

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1205055431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 HULL ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115543817",
            "telephone_number": "516-414-0531",
            "fax_number": "516-393-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92113",
            "telephone_number": "619-515-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3544 30th St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921044120",
            "country_code": "US",
            "telephone_number": "619-515-2424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4725 Market St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024715",
            "country_code": "US",
            "telephone_number": "619-515-2560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Merrick Ave",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115544748",
            "country_code": "US",
            "telephone_number": "516-393-8900",
            "fax_number": "516-393-8869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTELA",
        "first_name": "LUCILIA",
        "middle_name": "GONCALVES",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029216",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Maria Porras
• Porta Verum
• Krystal Rosebud Portalatin, B.A.
• Lilia Katherine Portales, DDS
• Debra Denise Portee
• Annalisa Porter, PHARM.D.
• Charmanay Porter
• Deanna Porter
• Dorothy Delidiich Porter
• Evette Porter

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.