Holly Portillo, NP is a medicare enrolled "Nurse Practitioner - Adult Health" in Rosebud, Texas. Her current practice location is
894 Us Highway 77, Rosebud, Texas. You can reach out to her office (for appointments etc.) via phone at
(254) 721-2563.
Holly Portillo is licensed to practice in Texas (license number AP126462) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063814101.
Provider's Profile
| Full Name | Holly Portillo |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Adult Health |
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| Location | 894 Us Highway 77, Rosebud, Texas |
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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: 1063814101
- Provider Enumeration Date: 09/19/2014
- Last Update Date: 01/17/2019
Medicare PECOS Information:
- PECOS PAC ID: 2860613221
- Enrollment ID: I20141028002043
Medical Identifiers
Medical identifiers for Holly Portillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063814101 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2200X | Nurse Practitioner - Adult Health | AP126462 (Texas) | 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. Holly Portillo allows following entities to bill medicare on her behalf.
| Entity Name | Vpa Of Texas Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679510499
PECOS PAC ID: 7618911660
Enrollment ID: O20050610000702 |
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| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20190520001486 |
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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. Holly 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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Holly Portillo, NP
894 Us Highway 77,
Rosebud, TX 76570-3325
Ph: (254) 721-2563 | Holly Portillo, NP
894 Us Highway 77,
Rosebud, TX 76570
Ph: (254) 721-2563 |
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