Individual provider Active NPI

Alexander Jay Porte, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1205285301
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036148637 Issued in IL
Practice address
3860 W Ogden Ave
Chicago, IL 60623-2460
Phone
(872) 588-3000
NPI assigned
Jun 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036148637 IL Primary

Addresses

Primary practice location

3860 W Ogden Ave
Chicago, IL 60623-2460

Mailing address

3860 W Ogden Ave
Chicago, IL 60623-2460
Phone (872) 588-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20210319001393 IL Practitioner - Family Practice 8628360575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawndale Christian Health CenterGroup PAC ID 2264336346, 124 clinicians

Practice addresses (Care Compare)

3860 W Ogden Ave
Chicago, IL 60623-2460
Phone (872) 588-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036148637ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawndale Christian Health Center CurrentSince Dec 16, 2020 Accepting new patients
Lawndale Christian Health Center Current Accepting new patients
Lawndale Christian Health Center CurrentSince Dec 16, 2020 Accepting new patients

Locations

3860 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

4696 Paysphere Cir
Chicago, IL 60674

Interoperability endpoints

  • Direct secure messaging: aporte691003@direct.ochin.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1205285301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTE",
        "first_name": "ALEXANDER",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036148637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.