Cecily Portillo, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P106133 Issued in NY

Practice address

2001 Marcus Ave Ste E128
New Hyde Park, NY 11042-1000

Phone

(516) 390-3525

NPI assigned

Jul 10, 2012

Last updated

Oct 3, 2021By the provider in NPPES

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Cecily Portillo Psychologist PLLC

  • Clinical Psychologist
  • Garden City, NY
  • NPI 1982544383
  NPD Authorized official
• Center for Cognitive and Dialectical Behavior Therapy

  • Clinical Psychologist
  • New Hyde Park, NY
  • NPI 1013131465
  NPD (past)

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633219200000",
    "number": "1972868586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 WEST 168TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323748",
            "telephone_number": "212-305-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE E128",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421000",
            "telephone_number": "516-390-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "CECILY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2021-10-03",
        "certification_date": "2021-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "P106133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew J Porges, MD
• Deborah Y Porges, MD
• Sarah Porras, NNP-BC
• Port Washington Gastroenterology, PC
• Kelly R Porta, PA
• Joel Evan Portnoy, M.D.
• Dominick Posillico, PA
• Agustin Posso, MD
• Jennifer Pothen, M.D.
• Maria G Pouliezos-Karayiannis, D.M.D

• Clinical Psychologist in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.