Carlos Portillo, is a medicare enrolled "Social Worker - Clinical" provider in Woodland Hills, California. His current practice location is
20501 Ventura Blvd, Woodland Hills, California. You can reach out to his office (for appointments etc.) via phone at
(818) 826-0253.
Carlos Portillo is licensed to practice in California (license number 112333) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679053342.
Healthcare Provider's Profile
| Full Name | Carlos Portillo |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 20501 Ventura Blvd, Woodland Hills, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1679053342
- Provider Enumeration Date: 08/21/2018
- Last Update Date: 03/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 9739624446
- Enrollment ID: I20240717001808
Medical Identifiers
Medical identifiers for Carlos Portillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1679053342 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | R12361610816 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 112333 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carlos Portillo allows following entities to bill medicare on his behalf.
| Entity Name | Tarzana Treatment Centers Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346842093
PECOS PAC ID: 5991897845
Enrollment ID: O20070822001488 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carlos Portillo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Carlos Portillo,
20501 Ventura Blvd Ste 170,
Woodland Hills, CA 91364-6258
Ph: (818) 826-0253 | Carlos Portillo,
20501 Ventura Blvd,
Woodland Hills, CA 91364-2337
Ph: (818) 826-0253 |
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