Active NPI
Deanna L Porte Keene, MD
- Internal Medicine Physician
- Munster, IN
National Provider Identifier
1265424675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01029185
- Practice address
- 1650 45TH Ave
Suite C
Munster, IN 46321-3962 - Phone
- (219) 924-2444
- Fax
- (219) 924-2488
- NPI assigned
- Aug 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01029185 | IN | Primary |
Addresses
Primary practice location
1650 45TH Ave
Suite C
Munster, IN 46321-3962
Mailing address
9660 Wicker Avenue
St John, IN 46373-9487
Phone (219) 924-2444
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000360206 | Other | IN | ANTHEM BCBS |
| 351107009014 | Other | IN | TRICARE |
| P0029848 | Other | IN | MEDICARE RAILROAD |
Other names 1
- Deanna Lynne Sporke Porte
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01029185 | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illiana Surgery & Medical Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Merrillville, IN
- NPI 1962401927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277078400000",
"number": "1265424675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9660 WICKER AVENUE",
"city": "ST JOHN",
"state": "IN",
"postal_code": "463739487",
"telephone_number": "219-924-2444",
"fax_number": "219-924-2488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 45TH AVE",
"address_2": "SUITE C",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463213962",
"telephone_number": "219-924-2444",
"fax_number": "219-924-2488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTE KEENE",
"first_name": "DEANNA",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-22",
"last_updated": "2010-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01029185",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000360206",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "351107009014",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P0029848",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEANNA",
"last_name": "PORTE",
"middle_name": "LYNNE SPORKE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.