Individual provider Active NPI

Allison Elizabeth Portillo, APRN

  • Family Nurse Practitioner
  • Largo, FL
National Provider Identifier
1811761638
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11028545 Issued in FL
Practice address
1775 E Bay Dr
Largo, FL 33771-2213
Phone
(727) 441-1508
NPI assigned
Nov 13, 2023
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11028545 FL Primary

Addresses

Primary practice location

1775 E Bay Dr
Largo, FL 33771-2213

Mailing address

1775 E Bay Dr
Largo, FL 33771-2213
Phone (727) 441-1508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20231122000152 FL Practitioner - Nurse Practitioner 8022466523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

1775 E Bay Dr
Largo, FL 33771-2213
Phone (727) 441-1508

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11028545FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Institute, LLC CurrentSince Oct 14, 2024 Accepting new patients
Advanced Urology Institute, LLC CurrentSince Oct 14, 2024 Accepting new patients
Advanced Urology Institute LLC Past Accepting new patients

Locations

609 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-9707

1775 E Bay Dr
Largo, FL 33771
Phone (727) 441-1508

506 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 427-9554

12109 County Road 103
Oxford, FL 34484
Phone (352) 205-8981

35095 US Highway 19 N
Ste 202
Palm Harbor, FL 34684
Phone (727) 771-0600

3890 Tampa Rd
Ste 401
Palm Harbor, FL 34684
Phone (727) 784-8870

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida

Organizations & group practices 3

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 4

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": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1811761638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712213",
            "telephone_number": "727-441-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712213",
            "telephone_number": "727-441-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "ALLISON",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11028545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.