Individual provider Active NPI

Raul M Portillo, MD

  • Hematology & Oncology Physician
  • San Antonio, TX
National Provider Identifier
1265473391
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G4193 Issued in TX
Practice address
1200 Brooklyn Ave Ste 115
San Antonio, TX 78212-4815
Phone
(210) 224-6531
Fax
(210) 226-0402
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X G4193 TX Primary
Medical Oncology Physician 207RX0202X G4193 TX

Addresses

Primary practice location

1200 Brooklyn Ave Ste 115
San Antonio, TX 78212-4815

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 5

IdentifierTypeStateIssuer
000V5772MedicaidNM
8R1527OtherTXBLUE CROSS OF TEXAS
123759601MedicaidTX
177173501MedicaidTX
123759602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060125000522 TX Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Medical Oncology 6406870740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine, Medical Oncology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

1200 Brooklyn Ave
Suite 115
San Antonio, TX 78212-4815
Phone (210) 224-6531

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 4, 2009 Accepting new patients
Texas Oncology PA Hematology & Oncology CurrentSince Feb 1, 2006 Accepting new patients
Texas Tech University Health Sciences Center El Paso Hematology & Oncology CurrentSince Aug 4, 2009 Accepting new patients
Texas Oncology PA Hematology & Oncology CurrentSince Feb 1, 2006 Accepting new patients

Locations

5419 N Lovington Hwy
Ste 25
Hobbs, NM 88240
Phone (432) 335-8275

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

1901 Grandview Ave
El Paso, TX 79902
Phone (915) 544-6750

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

1200 Brooklyn Ave
Ste 115
San Antonio, TX 78212
Phone (210) 224-6531

Interoperability endpoints

  • Direct secure messaging: raul.portillo@txo.ikm.direct-ci.com

Organizations & group practices 4

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 4

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1265473391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-437-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE STE 115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124815",
            "telephone_number": "210-224-6531",
            "fax_number": "210-226-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "RAUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "G4193",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "G4193",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000V5772",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TEXAS",
            "identifier": "8R1527",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123759601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177173501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123759602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.