Englewood Family Health Center, P.a

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ENGLEWOOD FAMILY HEALTH CENTER, P.A

Practice address

148 Engle St
Englewood, NJ 07631-2581

Phone

(201) 569-1530

Fax

(201) 569-6022

NPI assigned

Oct 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Diana M Portilla, M.D.NPI 1487769923

Title

Medical Director

Phone

(201) 926-1828

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana M Portilla, MD

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1487769923
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1366693145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 ENGLE STREET, SUITE NUMBER 1",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312581",
            "telephone_number": "201-569-1530",
            "fax_number": "201-569-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312581",
            "telephone_number": "201-569-1530",
            "fax_number": "201-569-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGLEWOOD FAMILY HEALTH CENTER, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "PORTILLA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-926-1828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0611859",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G11493",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Englewood Dermatology Center
• Englewood Ear Nose & Throat PC
• Englewood Eye Associates P.a.
• Englewood Eye Center, LLC
• Englewood Eye Center, LLC
• Englewood Healthcare Associates PC
• Englewood Hospital and Medical Center
• Englewood Hospital and Medical Center
• Englewood Hospital and Medical Center
• Englewood Hospital and Medical Center

• Internal Medicine Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.