Active NPI
Ross William Porter
- Pediatrics Physician
- Altamonte Springs, FL
National Provider Identifier
1053421164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME167637
- Practice address
- 475 Osceola St Ste 1100
Altamonte Springs, FL 32701-7857 - Phone
- (407) 831-6200
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 032642 | CT | |
| Pediatrics Physician | 208000000X | ME167637 | FL | Primary |
Addresses
Primary practice location
475 Osceola St Ste 1100
Altamonte Springs, FL 32701-7857
Mailing address
475 Osceola St Ste 1100
Altamonte Springs, FL 32701-7857
Phone (407) 831-6200
Other practice location 1
141B Hazard Avenue
Enfield, CT 06082
Phone (860) 749-3169
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001326421 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME167637 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittell, Levin and Jacobson | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- ross.porter.npi1053421164.phpct@direct.optumcare.masshiway.net
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Hollywood, FL
- NPI 1639138480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1053421164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 OSCEOLA ST STE 1100",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327017857",
"telephone_number": "407-831-6200",
"fax_number": "860-749-2670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 OSCEOLA ST STE 1100",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327017857",
"telephone_number": "407-831-6200"
}
],
"practiceLocations": [
{
"address_1": "141B Hazard Avenue",
"address_purpose": "LOCATION",
"city": "Enfield",
"state": "CT",
"postal_code": "06082",
"country_code": "US",
"telephone_number": "860-749-3169",
"fax_number": "860-749-2670",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PORTER",
"first_name": "ROSS",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2024-04-17",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "032642",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME167637",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001326421",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.