Michael James Porter, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1060 E Southern Ave Ste 106
Mesa, AZ 85204-5058

Phone

(480) 870-7400

Fax

(480) 906-2174

NPI assigned

Sep 30, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: michael.porter@hmg.gwaydirect.com

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.

• Archwell Health Professional Services of Arizona, LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1558026880
  Medicare reassignment

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1053928374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E SOUTHERN AVE STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045058",
            "telephone_number": "480-870-7400",
            "fax_number": "480-906-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E SOUTHERN AVE STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045058",
            "telephone_number": "480-870-7400",
            "fax_number": "480-906-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-30",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Thain Porter, DDS
• David Porter, LCSW
• Doran Porter, DPT
• Jason Alan Porter, NMD
• Maurice Antonio Porter
• Nathan Ray Porter, D.D.S.
• Ryan Troy Porter
• Shyra Porter
• Stephen Troy Porter, CRNA
• Sydney Porter, PA-S

• Medical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.