Individual provider Active NPI

Mark Douglas Porta Jr.

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1275890436
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
206897 Issued in LA
Practice address
1501 Kings Hwy
Lsuhsc Dept. of Gastroenterology
Shreveport, LA 71130
Phone
(318) 813-2502
NPI assigned
Apr 12, 2012
Last updated
Jul 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 206897 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Lsuhsc Dept. of Gastroenterology
Shreveport, LA 71130

Mailing address

1501 Kings Hwy
Lsuhsc Dept. of Gastroenterology
Shreveport, LA 71130
Phone (318) 813-2502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20160428002154 LA Practitioner - Internal MedicinePractitioner - GastroenterologyPractitioner - Emergency Medicine 2860795572 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine, Gastroenterology
Education
Louisiana State University School of Medicine in New Orleans, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lsuhn Billing LLCGroup PAC ID 0446337802, 203 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-6565

764 N Acadia Rd
Suite a
Thibodaux, LA 70301-5009
Phone (985) 446-1958

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.05 of 100Reported as group
Quality
82.12
Promoting interoperability
100
Improvement activities
40
Cost
71.37

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy52
Upper gastrointestinal (GI) endoscopy for acid reflux86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206897LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Aug 27, 2016 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Jun 26, 2018 Accepting new patients
Rapides Healthcare System LLC Internal Medicine CurrentSince Feb 22, 2019 Accepting new patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Jun 26, 2018 Accepting new patients
Lsuhn Billing LLC CurrentSince Jul 1, 2018 Accepting new patients
Rapides Healthcare System, LLC CurrentSince Feb 22, 2019 Accepting new patients
Main Street Physician Services LLC CurrentSince Mar 20, 2016 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Aug 27, 2016 Accepting new patients
Lsuhn Billing LLC CurrentSince Jul 1, 2018 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Past Accepting new patients

Locations

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

5131 Odonovan Dr
Ste 400
Baton Rouge, LA 70808

5131 Odonovan Dr
Ste 500
Baton Rouge, LA 70808
Phone (225) 374-0031

9032 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 358-4853

9103 Jefferson Hwy
Baton Rouge, LA 70809
Phone (225) 927-1190

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

2315 E Main St
Fl 3
New Iberia, LA 70560
Phone (337) 369-1100

764 N Acadia Rd
Ste A
Thibodaux, LA 70301
Phone (985) 446-1958

Organizations & group practices 10

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 7

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1275890436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "LSUHSC DEPT. OF GASTROENTEROLOGY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71130",
            "telephone_number": "318-813-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "LSUHSC DEPT. OF GASTROENTEROLOGY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71130",
            "telephone_number": "318-813-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTA",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "206897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.