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CARLA PORTILLO-MEDRANO NP
NPI 1124610654
Nurse Practitioner - Family in Detroit, MI

Active since February 05, 2021
5635 W FORT ST, DETROIT, MI 48209(734) 968-2566 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 8, 2023, Feb 5, 2021 (2 updates tracked since 2021).

About Carla Portillo-medrano Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLA PORTILLO-MEDRANO NP (NPI 1124610654) is an individual family provider in Detroit, Michigan, licensed in Michigan (4704324069) and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1124610654
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCARLA PORTILLO-MEDRANOCredential: NP
Location Address5635 W FORT STDetroit, MI 48209-3154
Mailing Address5635 W Fort StDetroit, MI 48209-3154 · (734) 968-2566
Phone(734) 968-2566
Sole ProprietorYes
Enumeration DateFebruary 5, 2021
Last NPPES UpdateApril 24, 20252 updates tracked since enumeration
NPPES CertifiedApril 24, 2025
✔ NPI 1124610654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MI · 4704324069
Also ListedRegistered NurseTaxonomy 163W00000X · License 4704324069 (MI)
5635 W FORT ST, Detroit, MI 48209
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHERRY E LAWRENCE R.N.
Registered Nurse (Community Health)
5635 W FORT ST
DETROIT, MI 48209
Wayne County (313) 849-3920
CHRISTEN KEMP FNP-BC
Nurse Practitioner (Family)
5635 W FORT ST
DETROIT, MI 48209
Wayne County (888) 360-9355
DR. SYMONE LESLIE MARTIN FOWLER MD
Family Medicine
5635 W FORT ST
DETROIT, MI 48209
Wayne County (313) 829-3920
FATIMA MARTIN
Social Worker
5635 W FORT ST
DETROIT, MI 48209
Wayne County (313) 849-3920
FATIMA BARBA
Doula
5635 W FORT ST
DETROIT, MI 48209
Wayne County (313) 644-1500
LORELEI E CLAIBORNE D.D.S
Dentist (Dental Public Health)
5635 W FORT ST
DETROIT, MI 48209
Wayne County (313) 849-3920
MS. ELLEN HARNISCH LMSW
Social Worker (Clinical)
5635 W FORT ST
DETROIT, MI 48209
Wayne County (313) 849-3920
DANIELA LOPEZ VIVES LMSW
Social Worker (Clinical)
5635 W FORT ST
DETROIT, MI 48209
Wayne County (313) 849-3920

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carla Portillo-medrano's NPI number?

The NPI number for Carla Portillo-medrano is 1124610654. It was assigned to this individual provider in the NPPES registry on February 5, 2021.

Where is Carla Portillo-medrano located?

Carla Portillo-medrano practices at 5635 W Fort St, Detroit, MI 48209. The listed phone number is (734) 968-2566.

What is Carla Portillo-medrano's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

What insurance does Carla Portillo-medrano accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Priority Health and UnitedHealthcare list Carla Portillo-medrano as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carla Portillo-medrano was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.