Individual provider Active NPI

Brittany Portonova, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Hazle Township, PA
National Provider Identifier
1124373246
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006405 Issued in PA
Practice address
50 Moisey Dr Ste 204
Hazle Township, PA 18202-9297
Phone
(570) 501-6730
NPI assigned
Jul 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006405 PA Primary

Addresses

Primary practice location

50 Moisey Dr Ste 204
Hazle Township, PA 18202-9297

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other identifiers 1

IdentifierTypeStateIssuer
103013382-0001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150710000445 PA Practitioner - Podiatry 7517279185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

700 E Broad St
LVPG Emergency Medicine
Hazleton, PA 18201-6835
Phone (570) 501-4193

Hospital & facility affiliations

  • Maylath Valley Health Systems, Inc. Home health agency, Sybertsville, PA, CCN 398041
  • Lehigh Valley Home Care Hazleton Home health agency, Hazleton, PA, CCN 397455
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

Merit-based Incentive Payment System (MIPS)

Final score
79.5 of 100Reported as group
Quality
66.14
Promoting interoperability
85
Improvement activities
40
Cost
74.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue35
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006405PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2015 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Hazleton Professional Services CurrentSince Jul 1, 2015 Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

50 Moisey Dr
Ste 202
Hazle Township, PA 18202
Phone (570) 501-6730

50 Moisey Dr
Ste 204
Hazle Township, PA 18202
Phone (570) 501-6730

50 Moisey Dr
Ste 109
Hazle Township, PA 18202
Phone (570) 501-6460

50 Moisey Dr
Ste 210
Hazle Township, PA 18202
Phone (570) 501-6380

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

26 Station Cir
Hazleton, PA 18202
Phone (570) 861-8710

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

Organizations & group practices 6

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 8

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": "1342310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1124373246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOISEY DR STE 204",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182029297",
            "telephone_number": "570-501-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTONOVA",
        "first_name": "BRITTANY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-15",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103013382-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazle Township, PA

Sources for this page

Verify at the official NPI Registry.