Individual provider Active NPI

Giulliana Maria Gonzalez Portillo, CRNP

  • Pediatric Nurse Practitioner
  • Washington, DC
National Provider Identifier
1225400757
Registry record updated Mar 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN1038874 Issued in DC
Practice address
2333 Ontario Rd NW
Attn: Marangely Nazario
Washington, DC 20009-2627
Phone
(202) 420-7175
Fax
(202) 232-2745
NPI assigned
Oct 23, 2015
Last updated
Mar 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R218295 MD
Pediatric Nurse Practitioner 363LP0200X 0024178826. VA
Pediatric Nurse Practitioner 363LP0200X RN1038874 DC Primary

Addresses

Primary practice location

2333 Ontario Rd NW
Attn: Marangely Nazario
Washington, DC 20009-2627

Mailing address

2333 Ontario Rd NW
Attn: Marangely Nazario
Washington, DC 20009-2627
Phone (202) 420-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20160318000696 DC Practitioner - Nurse Practitioner 8325345358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R218295MDMDPediatric Nurse Practitioner
0024178826.VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marys Center for Maternal and Child Care Inc CurrentSince Feb 23, 2016 Accepting new patients
Mary's Center for Maternal and Child Care, Inc CurrentSince Feb 23, 2016 Accepting new patients

Locations

100 Gallatin St NE
Washington, DC 20011
Phone (202) 545-0515

2333 Ontario Rd NW
Washington, DC 20009
Phone (202) 420-7175

3912 Georgia Ave NW
Washington, DC 20011
Phone (844) 796-2797

8908 Riggs Rd
Hyattsville, MD 20783
Phone (301) 422-5900

344 University Blvd W
Silver Spring, MD 20901
Phone (301) 439-0300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709337600000",
    "number": "1225400757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "address_2": "ATTN: MARANGELY NAZARIO",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627",
            "telephone_number": "202-420-7175",
            "fax_number": "202-232-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "address_2": "ATTN: MARANGELY NAZARIO",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627",
            "telephone_number": "202-420-7175",
            "fax_number": "202-232-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ PORTILLO",
        "first_name": "GIULLIANA",
        "middle_name": "MARIA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R218295",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024178826.",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "RN1038874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.