ALFREDO MANUEL PORTILLO AG-ACNP
NPI 1639852635
Nurse Practitioner - Acute Care in Apple Valley, CA

Q: What is Alfredo Portillo's NPI number?

The NPI number for Alfredo Portillo is 1639852635. It was assigned to this individual provider in the NPPES registry on August 8, 2023.

Q: What is Alfredo Portillo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Alfredo Portillo was last updated on August 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since August 08, 2023PECOS EnrolledAccepts Medicare Assignment

18300 CA-18, APPLE VALLEY, CA 92307(760) 242-2311 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Alfredo Manuel Portillo Ag-acnp NPPES

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

ALFREDO MANUEL PORTILLO AG-ACNP (NPI 1639852635) is an individual acute care provider in Apple Valley, California, licensed in California (95026013) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1639852635

Entity TypeIndividualMale

Primary Taxonomy363LA2100X

Provider Legal NameALFREDO MANUEL PORTILLOCredential: AG-ACNP

Location Address18300 CA-18Apple Valley, CA 92307

Mailing Address18310 Ca-18, Suite BApple Valley, CA 92307 · (760) 998-2312

Phone(760) 242-2311

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateAugust 8, 2023

NPPES CertifiedAugust 8, 2023

✔ NPI 1639852635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in CA · 95026013

18300 CA-18, Apple Valley, CA 92307

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alfredo Manuel Portillo Ag-acnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183087513

PECOS Enrollment IDI20230831002966

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92307 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

MR. JESUS A QUINONEZ NP

Nurse Practitioner