Humberto S. Portillo, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

116009 Issued in NY

Practice address

7910 34TH Ave
1D
Jackson Heights, NY 11372-2437

Phone

(718) 424-2029

Fax

(718) 429-0913

NPI assigned

Aug 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1407964828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 34TH AVE",
            "address_2": "1D",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722437",
            "telephone_number": "718-424-2029",
            "fax_number": "718-429-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 34TH AVE",
            "address_2": "1D",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722437",
            "telephone_number": "718-424-2029",
            "fax_number": "718-429-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "HUMBERTO",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "116009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shannon Potts
• Consuelo Trinidad Poveda, DDS
• Prachi Corporation
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• Olga Alejandra Preciado, LMSW

• Specialist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.