Alexis Adrian Portillo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2022-0133 Issued in NM

Practice address

11601 Montgomery Blvd NE
Albuquerque, NM 87111-2660

Phone

(505) 609-7896

NPI assigned

Mar 15, 2022

Last updated

Apr 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score

84.29 of 100Reported as group

Quality

71.09

Promoting interoperability

100

Improvement activities

40

Cost

76.53

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

82.35

Promoting interoperability

100

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aportillo104538@direct.phs.org

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.

• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment Care Compare group
• Duke City Urgent Care

  • Urgent Care Clinic/Center
  • Albuquerque, NM
  • NPI 1790185577
  Medicare reassignment
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470

  Single Specialty

  NPD
• Presbyterian Healthcare Services

  dba Espanola Hospital

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  Care Compare affiliation
• Presbyterian Healthcare Services

  dba Presbyterian Kaseman Psych Unit

  • Psychiatric Hospital Unit
  • Albuquerque, NM
  • NPI 1598740482
  Care Compare affiliation

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1407504731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 FLEMING RD",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "874136544",
            "telephone_number": "505-609-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112660",
            "telephone_number": "505-609-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "ALEXIS",
        "middle_name": "ADRIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-15",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2022-0133",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben Porter Jr., LADAC
• Ryan K. Porter, LMSW
• Stephanie Porter, M.A.
• Katherine Sharp Porterfield, PA-C
• Susan D Porterfield
• Alyssa Portillo
• Angelica Enez Portillo, RPH
• Bernadette Portillo, MSN, RN
• Delilah K Portillo
• Ada Portman, PT

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.

Verify at the official NPI Registry.