Deactivated NPI 1932118254 Deactivated / Inactive NPI Male Practitioner

Dr. Gustavo A De La Portilla , MD

General Practice • Miami, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gustavo De La Portilla has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 05, 2006

NPI Deactivation Date December 26, 2024

Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Gustavo De La Portilla, MD was a registered General Practice practicing in Miami, FL. Throughout an active medical career spanning 18 years, Dr. De La Portilla provided care at the practice location at 11452 QUAIL ROOST DR until profile deactivation on 2024-12-26.

Historical Medicare Part B clinical services included established patient outpatient office visit, physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp, routine ekg using at least 12 leads including interpretation and report. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

11452 Quail Roost Dr

Miami, FL 331576546

Telephone 3052551966

Fax 3052590147

Associated Practice Facility / Clinic

🏢 Hector Garcia Dpm Pa Facility NPI 1538211685

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Miami, FL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 36.1 Yrs

State Avg: 26.1 Yrs

Regional Practice Density

333 Specialists

Practicing in Miami, FL (2490 Statewide)

Telehealth Adoption Rate

7.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

50.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	43	36	$200.00	$98.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	676	87	$200.00	$99.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	72	44	$400.00	$140.52
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	42	17	$175.00	$44.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	660	105	$200.00	$81.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	51	$400.00	$117.82
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	67	24	$175.00	$43.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	580	104	$200.00	$79.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	146	75	$400.00	$116.08
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	51	24	$172.55	$43.53
93000 Routine ekg using at least 12 leads including interpretation and report	13	13	$95.00	$18.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	580	124	$200.00	$73.73
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	76	$400.00	$108.66
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	43	22	$150.00	$41.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$500.00	$169.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	577	110	$200.00	$73.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	146	80	$400.00	$107.49
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	48	28	$150.00	$41.03
93000 Routine ekg using at least 12 leads including interpretation and report	22	19	$95.00	$17.22
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$500.00	$167.45

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License FL ME83614

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Dr. Hector Garcia , DPM

Podiatrist - Foot & Ankle Surgery

NPI 1457331720

Doctor of Podiatric Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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NPI Profile Deactivated December 26, 2024

Record deactivated on December 26, 2024

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NPI Profile Active April 28, 2016

NPI status registered as active in NPPES database

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Updated Practice Location April 28, 2016

Registered at 11452 QUAIL ROOST DR, MIAMI, FL 331576546 (Tel: 3052551966)

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Updated Business Mailing Address April 28, 2016

Registered at 11452 QUAIL ROOST DR, MIAMI, FL 331576546 (Tel: 3052551966)

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Provider Name / Credentials Updated April 28, 2016

Recorded as GUSTAVO DE LA PORTILLA, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2016

General Practice (License #ME83614 in FL)

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Initial NPI Registration & Enumeration August 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1932118254

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 05, 2006

Last Update: April 28, 2016

Deactivation Date: December 26, 2024

Update or Correct Profile

Mailing Address

11452 Quail Roost Dr

Miami, FL 331576546

Phone: 3052551966

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.