DR. KIMBERLY ELISE PORTALE (D.O.) – Obstetrics & Gynecology Physician, NPI 1134482656
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,007 OBSTETRICS/GYNECOLOGY in CA
Provider Addresses for DR. KIMBERLY ELISE PORTALE (D.O.)
400 N PEPPER AVE
COLTON, CA 923241801
Phone: (909) 580-3362
Type: Location
310 W Losey St
Scott AFB, IL 622255250
Phone: (618) 256-7018
Type: Location
1 SAINT ELIZABETH BLVD
O FALLON, IL 622691099
Phone: (618) 234-2120
Type: Mailing
310 W LOSEY ST
SCOTT AFB, IL 622255250
Phone: (618) 256-7018
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $90.
Total Amount is formed as General ($90) + Research ($0) + Ownership ($0) = $90.
Last reported payment date: 2023-12-13 • Largest payer in this snapshot: Organon LLC ($68).
Total Amount
$90
General + Research + Ownership
Payments
2
Total payment records
General Amount
$90
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organon LLC | $68 |
| Gynesonics, Inc. | $22 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-08-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240826000509 | I | Obstetrics/Gynecology | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92324)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | IL | |
| Hospitalist, Obstetrics/Gynecology | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| Obstetrics/Gynecology, Hospitalist | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL |
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