NPIMap

Individual provider Active NPI

Miguel Portocarrero, MD

  • Nephrology Physician
  • Kissimmee, FL
National Provider Identifier
1437284049
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME100657 Issued in FL
Practice address
1101 N Central Ave
Kissimmee, FL 34741-4405
Phone
(407) 933-2210
Fax
(407) 933-6428
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME100657 FL
Nephrology Physician 207RN0300X ME100657 FL Primary

Addresses

Primary practice location

1101 N Central Ave
Kissimmee, FL 34741-4405

Mailing address

3885 Oakwater Cir
Orlando, FL 32806-6257
Phone (407) 816-5700

Other practice location 1

4555 Pleasant Hill Rd
Kissimmee, FL 34759-3422
Phone (407) 933-2210

Other identifiers 2

IdentifierTypeStateIssuer
000204400MedicaidFL
59-1561574OtherFLTAX ID

Other names 1

  • Dr. Miguel Portocarrero Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081013000476 FL Practitioner - Internal MedicinePractitioner - Nephrology 7911075312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Florida Kidney Specialists IncGroup PAC ID 6608233705, 38 clinicians

Practice addresses (Care Compare)

1121 N Central Ave
Kissimmee, FL 34741-4405
Phone (407) 933-2210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME100657FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Central Florida, P.a. Nephrology CurrentSince Aug 1, 2013 Accepting new patients
Central Florida Kidney Specialists Inc Nephrology CurrentSince Mar 1, 2023 Accepting new patients

Locations

1101 N Central Ave
Kissimmee, FL 34741
Phone (407) 284-1993

1121 N Central Ave
Ste B
Kissimmee, FL 34741
Phone (407) 933-1221

1121 N Central Ave
Kissimmee, FL 34741
Phone (407) 933-1221

3885 Oakwater Cir
Orlando, FL 32806
Phone (407) 816-5700

2501 N Orange Ave
Ste 537N
Orlando, FL 32804
Phone (407) 894-4693

4555 Pleasant Hill Rd
Poinciana, FL 34759
Phone (407) 348-1780

27 E 13th St
Saint Cloud, FL 34769

807 S Orlando Ave
Ste C
Winter Park, FL 32789
Phone (407) 894-4693

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: miguel.portocarrero@direct.davitaphysiciansolutions.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1437284049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066257",
            "telephone_number": "407-816-5700",
            "fax_number": "407-812-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414405",
            "telephone_number": "407-933-2210",
            "fax_number": "407-933-6428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4555 Pleasant Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347593422",
            "country_code": "US",
            "telephone_number": "407-933-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTOCARRERO",
        "first_name": "MIGUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME100657",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME100657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000204400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "59-1561574",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIGUEL",
            "last_name": "PORTOCARRERO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.