Mario Jose Portocarrero, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J9277 Issued in TX

Practice address

6550 Mapleridge St
Suite 101 Ac
Houston, TX 77081-4600

Phone

(713) 774-1401

Fax

(713) 774-1467

NPI assigned

Nov 8, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Mario J. Portocarrero M.D., P.a.

  • Pediatrics Physician
  • Houston, TX
  • NPI 1174558670
  NPD (past) Authorized official

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1235208679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 MAPLERIDGE ST",
            "address_2": "SUITE 101AC",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770814600",
            "telephone_number": "713-774-1401",
            "fax_number": "713-774-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 MAPLERIDGE ST",
            "address_2": "SUITE 101 AC",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770814600",
            "telephone_number": "713-774-1401",
            "fax_number": "713-774-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTOCARRERO",
        "first_name": "MARIO",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J9277",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01043128A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121331603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121331604",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Portis Transportation
• Crystal Portis, LMSW
• Moneisha Portis
• Regina Patrice Portis
• Benjamin Lee Portnoy, MD
• Jose Portugal Gonzales, MD
• David Alexander Portugal, MD, FACC
• Jorge Ignacio Portuondo, MD
• Maria C Posa, L.AC
• Michael Posada Orozco, D.M.D., M.S.D.

• Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.