Individual provider Active NPI

Edward A Porrata, M.D.

  • Pediatrics Physician
  • New Braunfels, TX
National Provider Identifier
1114944048
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G2206 Issued in TX
Practice address
312 FM 306 Ste 108
New Braunfels, TX 78130-0301
Phone
(830) 302-4260
Fax
(830) 214-6530
NPI assigned
Jul 16, 2006
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 G2206 TX Primary

Addresses

Primary practice location

312 FM 306 Ste 108
New Braunfels, TX 78130-0301

Mailing address

PO Box 701950
San Antonio, TX 78270-1950
Phone (210) 981-1975

Other identifiers 1

IdentifierTypeStateIssuer
8BW920OtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050811001114 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2264461912 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G2206TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Emergency Partners LLC Emergency Medicine CurrentSince Aug 7, 2018 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine Past Accepting new patients

Locations

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1114944048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701950",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782701950",
            "telephone_number": "210-981-1975",
            "fax_number": "210-614-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 FM 306 STE 108",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781300301",
            "telephone_number": "830-302-4260",
            "fax_number": "830-214-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRATA",
        "first_name": "EDWARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G2206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8BW920",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

Verify at the official NPI Registry.