Individual provider Active NPI

Robert A Porche, P.T.

  • Orthopedic Physical Therapist
  • Metairie, LA
National Provider Identifier
1083884639
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
03522 Issued in LA
Practice address
3939 Houma Blvd
Suite 17
Metairie, LA 70006-2931
Phone
(504) 885-9121
Fax
(504) 885-0322
NPI assigned
Mar 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 03522 LA Primary

Addresses

Primary practice location

3939 Houma Blvd
Suite 17
Metairie, LA 70006-2931

Mailing address

3939 Houma Blvd
Suite 17
Metairie, LA 70006-2931
Phone (504) 885-9121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080915000448 LA Practitioner - Physical Therapist in Private Practice 1456427541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3939 Houma Blvd
Metairie, LA 70006-2921
Phone (504) 885-9121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03522LAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoptic'S Inc. Physical Therapist CurrentSince Aug 8, 2008 Accepting new patients

Locations

3939 Houma Blvd
Ste 17
Metairie, LA 70006
Phone (504) 812-6211

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1083884639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 HOUMA BLVD",
            "address_2": "SUITE 17",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062931",
            "telephone_number": "504-885-9121",
            "fax_number": "504-885-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 HOUMA BLVD",
            "address_2": "SUITE 17",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062931",
            "telephone_number": "504-885-9121",
            "fax_number": "504-885-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORCHE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "LA",
            "license": "03522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.