Active NPI
Raul M Portillo, MD
- Hematology & Oncology Physician
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- G4193
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000V5772 | Medicaid | NM | |
| 8R1527 | Other | TX | BLUE CROSS OF TEXAS |
| 123759601 | Medicaid | TX | |
| 177173501 | Medicaid | TX | |
| 123759602 | Medicaid | TX |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Other, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1200 Brooklyn Ave
Suite 115
San Antonio, TX 78212-4815
Phone (210) 224-6531
Hospital & facility affiliations
- Methodist Hospital
- Baptist Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.12 of 100
- 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center El Paso | Current | Accepting new patients | |
| Texas Oncology PA | Hematology & Oncology | Current | Accepting new patients |
| Texas Tech University Health Sciences Center El Paso | Hematology & Oncology | Current | Accepting new patients |
| Texas Oncology PA | Hematology & Oncology | Current | 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
- 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.
-
- Internal Medicine Physician
- El Paso, TX
- NPI 1598705055
Hematology & Oncology
-
- Neurological Surgery Physician
- El Paso, TX
- NPI 1457913444
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1124074273
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1689627655
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1952348021
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1598744856
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.