Individual provider Active NPI

Ross William Porter

  • Pediatrics Physician
  • Altamonte Springs, FL
National Provider Identifier
1053421164
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME167637 Issued in FL
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

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
001326421MedicaidCT

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

LicenseStateTypeSpecialty
ME167637FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.