Mountainstate Infectious Disease, PLLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

MOUNTAINSTATE INFECTIOUS DISEASE, PLLC

Doing business as

Mountainstate Infectious Disease

Practice address

215 W Main St Ste B
Bridgeport, WV 26330-1888

Phone

(301) 641-1822

Fax

(304) 250-9933

NPI assigned

Jan 16, 2019

Last updated

Jan 16, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dino Delaportas, MDNPI 1639124159

Title

MD/Owner

Phone

(304) 641-1822

Specialties & licenses 1

Addresses

Other names 1

• MOUNTAINSTATE INFECTIOUS DISEASE Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dino James Delaportas, M.D.

  • Infectious Disease Physician
  • Bridgeport, WV
  • NPI 1639124159
  Medicare reassignment Care Compare group NPD Authorized official
• Lowell Larew, PA-C

  • Medical Physician Assistant
  • Morgantown, WV
  • NPI 1265616841
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1114491792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 POINT OF VW",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301082",
            "telephone_number": "304-641-1822",
            "fax_number": "304-250-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W MAIN ST STE B",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301888",
            "telephone_number": "301-641-1822",
            "fax_number": "304-250-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINSTATE INFECTIOUS DISEASE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "DELAPORTAS",
        "authorized_official_first_name": "DINO",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "304-641-1822",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNTAINSTATE INFECTIOUS DISEASE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mountainear Audiology & Hearing Aid Center, LLC
• Mountaineer Family Practice PLLC
• Mountaineer Medical Office Building Pharmacy (Mountaineer Medical Pharmacy)
• Mountaineer Medical Pharmacy LLC
• Mountaineer Orthodontics, PLLC (Drs. Lacy, Weidman & Hazey III)
• Khaldoun Mohamad Mozahem, MD
• Matthew Mullenax
• Megan Muncy, ARNP
• Rachel Marie Muncy
• Hattie Murphy

• Infectious Disease Physician in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Infectious Disease Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.