Carrie Kraeger Porter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006893 Issued in MI

Practice address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Phone

(734) 936-6666

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Carrie Elizabeth Porter Former name

Medicare fee-for-service enrollment

Enrolled in MI, PA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Regents of the University of Michigan

  • Physician Assistant
  • Ann Arbor, MI
  • NPI 1689609448
  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1265867113

  Physician Assistant

  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1003103003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Church St",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187023507",
            "country_code": "US",
            "telephone_number": "570-808-3100",
            "fax_number": "570-808-8935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "CARRIE",
        "middle_name": "KRAEGER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063198",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "PORTER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Porath, MD
• Megan Porras
• Cynthia D Porritt-Rodriguez
• Alyssa Portelli
• Alana Monet Porter
• Katherine Porter, PH.D.
• Kyoko Kobayashi Porter
• Marcia Dianne Porter, RN
• Tiffany Adaeze-Ofili Porter, PHARMD
• Brooke Posada

• Physician Assistant in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.