Individual provider Active NPI

Pedro Portes, ACNP

  • Nurse Practitioner
  • Orange, CA
National Provider Identifier
1316375744
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23628 Issued in CA
Practice address
101 The City Dr S BLDG 25
Orange, CA 92868-3201
Phone
(714) 456-6699
NPI assigned
Oct 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 23628 CA
Nurse Practitioner 363L00000X 23628 CA Primary

Addresses

Primary practice location

101 The City Dr S BLDG 25
Orange, CA 92868-3201

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986

Other practice location 1

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-5513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150423000048 CA Practitioner - Nurse Practitioner 4789813825 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UC RegentsGroup PAC ID 7416869516, 316 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7002

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23628CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince May 1, 2017 Accepting new patients
Hospitalist Medicine Physicians of California, Inc CurrentSince Jul 1, 2015 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
UC Regents CurrentSince Mar 9, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince May 1, 2017 Accepting new patients
UC Regents CurrentSince Mar 9, 2020 Accepting new patients
UC Regents Current Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

643 W East Ave
Chico, CA 95926
Phone (530) 342-0502

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 25
Orange, CA 92868
Phone (714) 456-5731

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

2315 Stockton Blvd
#5
Sacramento, CA 95817
Phone (916) 703-3050

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

2315 Stockton Blvd
Rm 6312
Sacramento, CA 95817
Phone (919) 368-0082

2221 Stockton Blvd
Ste E
Sacramento, CA 95817
Phone (916) 734-2680

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1316375744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S BLDG 25",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-6699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "916-734-5513",
            "fax_number": "916-734-5378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTES",
        "first_name": "PEDRO",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "23628",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.