Individual provider Active NPI

Jose Portillo, CRNA

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
National Provider Identifier
1235761362
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP61017594 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-4379
Phone
(206) 520-5000
NPI assigned
Feb 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP61017594 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-4379

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other practice location 1

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200527000673 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961823125 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians
Precision Anesthesia Services PLLCGroup PAC ID 3072094531, 2 clinicians

Practice addresses (Care Compare)

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

450 NW Gilman Blvd
Suite 303
Issaquah, WA 98027-2483
Phone (425) 310-2542

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
80.9
Improvement activities
40
Cost
75.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP61017594WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Washington Medical Group, Inc, PS CurrentSince Jun 1, 2020 Accepting new patients
Physicians Anesthesia Service PLLC Current Accepting new patients
Seattle Hand Surgery Group PC CurrentSince Jun 1, 2020 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 22, 2023 Accepting new patients
Precision Anesthesia Services, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 4, 2025 Accepting new patients
The Association of University Physicians CurrentSince Nov 14, 2023 Accepting new patients

Locations

21600 Highway 99
Ste 260
Edmonds, WA 98026
Phone (425) 774-2650

450 NW Gilman Blvd
Ste 303
Issaquah, WA 98027
Phone (425) 310-2542

11335 NE 122nd Way
Ste 105
Kirkland, WA 98034
Phone (206) 899-5479

11800 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-4500

1229 Madison St
Ste 1440
Seattle, WA 98104
Phone (206) 625-0578

11027 Meridian Ave N
Ste 100
Seattle, WA 98133
Phone (206) 365-4492

501 N 34th St
Ste 101
Seattle, WA 98103
Phone (206) 838-1777

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

600 Broadway
Ste 270
Seattle, WA 98122
Phone (206) 381-0269

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1235761362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981954379",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 Broadway",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224379",
            "country_code": "US",
            "telephone_number": "206-386-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "JOSE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-06",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61017594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.