Individual provider Active NPI

Vicki Marlo Porges, M.D.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1053497941
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
220014 Issued in NY
Practice address
36 N Moore St
New York, NY 10013-2438
Phone
(212) 925-3636
Fax
(212) 925-0633
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 220014 NY Primary

Addresses

Primary practice location

36 N Moore St
New York, NY 10013-2438

Mailing address

36 N Moore St
New York, NY 10013-2438
Phone (212) 925-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20231220003728 NY Practitioner - Pediatric Medicine 9931559614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
220014NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Pediatrics CurrentSince Feb 1, 2024 Accepting new patients
New York University CurrentSince Feb 1, 2024 Accepting new patients

Locations

555 Laguardia Pl
New York, NY 10012
Phone (212) 263-2446

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: vporges44069@nyumc.direct-ci.com

Organizations & group practices 2

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053497941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 N MOORE ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132438",
            "telephone_number": "212-925-3636",
            "fax_number": "212-925-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N MOORE ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132438",
            "telephone_number": "212-925-3636",
            "fax_number": "212-925-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORGES",
        "first_name": "VICKI",
        "middle_name": "MARLO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "220014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.