Individual provider Active NPI

Jennifer Marie Porto, PA-C

  • Physician Assistant
  • Overland Park, KS
National Provider Identifier
1104935303
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2006022546 Issued in MO
Practice address
10600 Mastin St
Overland Park, KS 66212-5723
Phone
(913) 469-6447
Fax
(913) 338-1311
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2006022546 MO Primary
Physician Assistant 363A00000X T00749 KS

Addresses

Primary practice location

10600 Mastin St
Overland Park, KS 66212-5723

Mailing address

PO Box 741331
Atlanta, GA 30374-1331
Phone (913) 469-0503

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20061025000750 KS Practitioner - Physician Assistant 4385648385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overland Park Surgical Specialties LLCGroup PAC ID 9234318502, 86 clinicians

Practice addresses (Care Compare)

10500 Quivira Rd
Overland Park, KS 66215-2306
Phone (913) 541-5000

10600 Mastin St
Overland Park, KS 66212-5723

Hospital & facility affiliations

  • Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185
  • Overland Park Reg Med Ctr Hospital, Overland Park, KS, CCN 170176

Merit-based Incentive Payment System (MIPS)

Final score
84.84 of 100Reported as group
Quality
78.92
Promoting interoperability
99
Improvement activities
40
Cost
71.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
T00749KSMDPhysician Assistant
2006022546MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
College Park Family Care Center, P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennifer.porto@hca2.eclinicaldirectplus.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1356912000000",
    "number": "1104935303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741331",
            "telephone_number": "913-469-0503",
            "fax_number": "913-469-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 MASTIN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125723",
            "telephone_number": "913-469-6447",
            "fax_number": "913-338-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTO",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2006022546",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "T00749",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.