Port Homecare Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

012597 Issued in TX

Legal business name

PORT HOMECARE SERVICES, INC.

Practice address

5525 S Staples St Ste A7
Corpus Christi, TX 78411-5359

Phone

(361) 854-2273

Fax

(361) 854-6419

NPI assigned

May 27, 2005

Last updated

Nov 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Larry Martinez

Title

President, Administrator,Ceo/Cfo

Phone

(361) 854-2273

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285637900. Details of each certification follow.

• CCN 459268 Home health agency · Active · Details

Home health agency certification: CCN 459268

Legal name

PORT HOMECARE SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 8, 1997

Last certification

Nov 24, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 2, 1996 in TX

Enrollment address

5525 S Staples St
Ste A7
Corpus Christi, TX 78411-5359

Listed as

Port Homecare Services, Inc.CCN 459268 · All quality measures

Overall star rating

4 of 5

Ownership

Proprietary

Certified

May 8, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mario A Martinez, M.D.

  • Specialist
  • Corpus Christi, TX
  • NPI 1861401739

  Home health agency

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1285637900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 S STAPLES ST STE A7",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784115359",
            "telephone_number": "361-854-2273",
            "fax_number": "361-854-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 S STAPLES ST STE A7",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784115359",
            "telephone_number": "361-854-2273",
            "fax_number": "361-854-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT HOMECARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT, ADMINISTRATOR,CEO/CFO",
        "authorized_official_telephone_number": "361-854-2273"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "005247",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "012597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024322201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02432201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Diane Ponder, MD
• Kirstie Angeli Ponte
• Anita Pool, FNP-C
• Nancy Porras
• Port Avenue Drugs Inc (Port Avenue Drug Store)
• Norberto Portales
• Tashenina Porter-Lloyd
• John Richard Porter, MD
• Mary Beth Porter, MA, LCDC, LPC ASSOC
• Sandra Portillo-Barrera, CFNP

• Home Health Agency in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.