Individual provider Active NPI

Stephen Gregory Portera, M.D.

  • Urology Physician
  • Memphis, TN
National Provider Identifier
1205803608
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD25742 Issued in TN
Practice address
6215 Humphreys Blvd Ste 110
Memphis, TN 38120-2382
Phone
(901) 227-9610
Fax
(901) 227-9615
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD25742 TN Primary
Obstetrics & Gynecology Physician 207V00000X 25742 TN

Addresses

Primary practice location

6215 Humphreys Blvd Ste 110
Memphis, TN 38120-2382

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other identifiers 5

IdentifierTypeStateIssuer
3800896MedicaidTN
4015978OtherTNBCBST
07659397MedicaidMS
04123847MedicaidMS
97375OtherARBCBS AR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20080609000843 TN Practitioner - Obstetrics/GynecologyPractitioner - Urology 1456421056 Reassigns benefits to 1 organization
Practice locations: Germantown, TN; Memphis, TN

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
Tulane University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1785 Nonconnah Blvd
Suite 108
Memphis, TN 38132-2139
Phone (901) 344-0101

36 Capital Way
Suite E
Atoka, TN 38004-7986
Phone (901) 837-6801

6215 Humphreys Blvd
Memphis, TN 38120-2382

6225 Humphreys Blvd
Memphis, TN 38120-2373
Phone (901) 227-9000

8040 Wolf River Blvd
Germantown, TN 38138-1773

8059 Stage Hills Blvd
Suite 104
Bartlett, TN 38133-4071
Phone (901) 383-4515

8138 Country Village Dr
Cordova, TN 38016-2029
Phone (901) 725-8606

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25742TNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc CurrentSince Jun 1, 2023 Accepting new patients
Baptist Memorial Medical Group Inc Obstetrics & Gynecology CurrentSince Jun 1, 2023 Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Past Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

6215 Humphreys Blvd
Ste 110
Memphis, TN 38120
Phone (901) 227-9610

6225 Humphreys Blvd
Memphis, TN 38120
Phone (901) 227-2727

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Interoperability endpoints

  • Direct secure messaging: sportera14027@direct.bmhcc.org
  • Direct secure messaging: sportera33351@mlh.direct-ci.com

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 6

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1205803608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD STE 110",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202382",
            "telephone_number": "901-227-9610",
            "fax_number": "901-227-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTERA",
        "first_name": "STEPHEN",
        "middle_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD25742",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "25742",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3800896",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4015978",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07659397",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04123847",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AR",
            "identifier": "97375",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.