Active NPI
Jake Portillo, MD
- Physical Medicine & Rehabilitation Physician
- Virginia Beach, VA
National Provider Identifier
1710567110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 0101285892
- Practice address
- 5716 Cleveland St Ste 200
Virginia Beach, VA 23462-1784 - Phone
- (757) 490-4802
- NPI assigned
- Apr 9, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 125080756 | IL | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 0101285892 | VA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5716 Cleveland St Ste 200
Virginia Beach, VA 23462-1784
Mailing address
1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1244
Other practice location 1
26W171 Roosevelt Rd
Wheaton, IL 60187-6002
Phone (630) 909-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Texas a & M University System, HSC, College of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5716 Cleveland St
Suite 200
Virginia Beach, VA 23462-1784
Phone (757) 490-4802
Hospital & facility affiliations
- Sentara Leigh Hospital
- Sentara Virginia Beach General Hospital
- Sentara Princess Anne Hospital
- Sentara Albemarle Medical Center
- Bon Secours Maryview Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125080756 | IL | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethesda Chevy Chase Orthopaedic Associates, LLC | Multi-Specialty | Current | Accepting new patients |
| Bethesda Chevy Chase Orthopaedic Associates, LLC | Current | Accepting new patients |
Locations
5716 Cleveland St
Ste 200
Virginia Beach, VA 23462
Phone (757) 502-8583
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Bethesda, MD
- NPI 1477583599
Multi-Specialty, VA
-
- Durable Medical Equipment & Medical Supplies
- Bethesda, MD
- NPI 1851759898
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1629038336
-
- General Acute Care Hospital
- Norfolk, VA
- NPI 1811957681
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1528028396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761091200000",
"number": "1710567110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S MAIN ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044917",
"telephone_number": "817-702-1244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5716 CLEVELAND ST STE 200",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234621784",
"telephone_number": "757-490-4802"
}
],
"practiceLocations": [
{
"address_1": "26W171 Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Wheaton",
"state": "IL",
"postal_code": "601876002",
"country_code": "US",
"telephone_number": "630-909-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PORTILLO",
"first_name": "JAKE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "IL",
"license": "125080756",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "VA",
"license": "0101285892",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.