MR. JOB PORTILLO LOPEZ (FNP) – Family Nurse Practitioner, NPI 1871565796
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for MR. JOB PORTILLO LOPEZ (FNP)
81767 DR CARREON BLVD STE 102
INDIO, CA 922015598
Phone: (760) 863-5355
Fax: (760) 863-5885
Type: Location
57370 29 Palms Hwy Ste 203
Yucca Valley, CA 922842900
Phone: (760) 398-0606
Type: Location
45677 Oasis St
Indio, CA 922014564
Phone: (760) 398-0606
Type: Location
52565 Cesar Chavez St Ste 104
Coachella, CA 922361534
Phone: (760) 398-0606
Type: Location
Gentle Breeze Drive, Indio, Riverside County, California, 92201, United States
INDIO, CA 922018478
Phone: (760) 578-5612
Fax: (760) 863-5885
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 33 Open Payments records for all available years, with a total value of $839.
Total Amount is formed as General ($839) + Research ($0) + Ownership ($0) = $839.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($98).
Total Amount
$839
General + Research + Ownership
Payments
33
Total payment records
General Amount
$839
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $98 |
| PFIZER INC. | $98 |
| SHIELD THERAPEUTICS INC | $75 |
| ABBVIE INC. | $74 |
| Abbott Laboratories | $73 |
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: 2005-05-20
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 |
|---|---|---|---|---|
| I20050520001047 | I | Nurse Practitioner | CA | 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 92201)
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