Anthony Jerome Porter, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME96233 Issued in FL

Practice address

1515 W Nasa Blvd
Suite 101
Melbourne, FL 32901-2605

Phone

(321) 308-0659

Fax

(321) 309-2881

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Medical University of South Carolina College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Porter Premier Dermatology and Surgery Center, PLLCGroup PAC ID 0749562452, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aporter71835@epicdirect.hf.org

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

• Porter Premier Dermatology and Surgery Center, PLLC

  • Dermatology Physician
  • Melbourne, FL
  • NPI 1104152495
  Medicare reassignment Care Compare group NPD Authorized official
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surgery

  • Dermatology Physician
  • Orlando, FL
  • NPI 1316105885
  NPD (past)
• Omni Healthcare, Inc.

  • Specialist
  • Melbourne, FL
  • NPI 1134191323
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1013957133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W NASA BLVD",
            "address_2": "SUITE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012605",
            "telephone_number": "321-308-0659",
            "fax_number": "321-309-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W NASA BLVD",
            "address_2": "SUITE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012605",
            "telephone_number": "321-308-0659",
            "fax_number": "321-309-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "ANTHONY",
        "middle_name": "JEROME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01058940A",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME96233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7650363",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1358244",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55044",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276029100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "246877",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00415676",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darlene Go Popat, M.D.
• Jessica R Pope, SLP
• Karen S Popovich, OT, CHT
• Floro Porciuncula, MD
• Porter Premier Dermatology and Surgery Center, PLLC
• Whitney Portillo, FNP
• Arielle Poteau
• John H Potomski Jr., DO CMA
• Wendy Potter, M.ED., LMHC
• Charles Eugene Potts, MD

• Dermatology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.