Michelle Ann Portis, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP144279 Issued in TX

Practice address

1314 E Sonterra Blvd Ste 5102
San Antonio, TX 78258-4289

Phone

(210) 490-8888

Fax

(210) 496-6865

NPI assigned

Dec 9, 2019

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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.

• Alpha Pediatrics, PA

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1649464728
  NPD (past)
• St. Luke'S Physician Group, Inc.

  • Maternal & Fetal Medicine Physician
  • Fountain Hill, PA
  • NPI 1003867623
  NPD (past)

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1508403585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25111 REMINGTON OAKS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782612903",
            "telephone_number": "210-364-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD STE 5102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584289",
            "telephone_number": "210-490-8888",
            "fax_number": "210-496-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTIS",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2022-07-20",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP144279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genesis Eunice Portillo, RBT
• Laura L Portillo, RN
• Olivia Rae Portillo, DNP, FNP-C
• Raul M Portillo, MD
• Ebony Portis, LCSW
• Stasie Portis
• Alberto Porto, LMT
• Reanna Posada Cano
• Sandra G Posada, MSW
• John J Posch, LCDC

• Pediatric Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.