MS. MAYRA MARLENE PORTILLO WHNP-BC
NPI 1780296384
Nurse Practitioner - Women's Health in Riverside, CA
About Ms. Mayra Marlene Portillo Whnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. MAYRA MARLENE PORTILLO WHNP-BC (NPI 1780296384) is an individual women's health provider in Riverside, California, licensed in California (95013841) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ms. Mayra Marlene Portillo Whnp-bc 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.
Medicare Billing Reassignment
Medicare enrollment records show Mayra Portillo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Anaheim, CA 92807
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92506 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
RIVERSIDE, CA 92506
RIVERSIDE, CA 92506
RIVERSIDE, CA 92506
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 Mayra Portillo's NPI number?
The NPI number for Mayra Portillo is 1780296384. It was assigned to this individual provider in the NPPES registry on August 17, 2020.
Where is Mayra Portillo located?
Mayra Portillo practices at 3772 Tibbetts St, Riverside, CA 92506. The listed phone number is (888) 743-7526.
What is Mayra Portillo's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.
Is Mayra Portillo enrolled in Medicare?
Yes. Mayra Portillo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mayra Portillo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mayra Portillo reassigns Medicare benefits to Southern California Permanente Medical Group (Anaheim, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mayra Portillo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mayra Portillo was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Ms. Mayra Marlene Portillo, WHNP-BC · NPI 1780296384
Women's Health physician in Riverside, California. Individual provider, active in the CMS NPPES registry since August 17, 2020.
## Identity
- **NPI:** 1780296384 (Entity type: Individual)
- **Enumerated:** August 17, 2020
- **Primary specialty:** Nurse Practitioner - Women's Health · taxonomy 363LW0102X
- **State license:** 95013841 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3772 TIBBETTS ST, Riverside, CA 92506-2605
- **Phone:** (888) 743-7526
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1952333460, Anaheim, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** June 27, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1780296384) · Data from the CMS NPPES public registry.