Individual provider Active NPI

Beth Ann Porter

  • Nurse Practitioner
  • Olean, NY
National Provider Identifier
1205338613
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
565200 Issued in NY
Practice address
515 Main St
Olean, NY 14760-1513
Phone
(716) 375-7317
Fax
(716) 375-7319
NPI assigned
Mar 1, 2018
Last updated
Mar 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 565200 NY Primary

Addresses

Primary practice location

515 Main St
Olean, NY 14760-1513

Mailing address

PO Box 708760
Sandy, UT 84070-8760
Phone (801) 352-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180416000277 NY Practitioner - Nurse Practitioner 8628331196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zafar K Mirza Gastroenterology PLLCGroup PAC ID 9234286089, 3 clinicians

Practice addresses (Care Compare)

2223 W State St
Suite 115
Olean, NY 14760-1938
Phone (716) 372-5601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
565200NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Zafar K Mirza Gastroenterology PLLC CurrentSince Jul 1, 2020 Accepting new patients
Apogee Medical Group, New York, PC CurrentSince Mar 10, 2018 Accepting new patients

Locations

2223 W State St
Ste 115
Olean, NY 14760
Phone (716) 372-5601

515 Main St
Olean, NY 14760
Phone (716) 373-2600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1205338613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708760",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708760",
            "telephone_number": "801-352-9500",
            "fax_number": "801-352-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601513",
            "telephone_number": "716-375-7317",
            "fax_number": "716-375-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "BETH",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "565200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

Verify at the official NPI Registry.