NPIMap

Individual provider Active NPI

Mark Porter, MD

  • Orthopaedic Surgery Physician
  • Pueblo, CO
National Provider Identifier
1285714402
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
45239 Issued in CO
Practice address
3530 E Spaulding Ave
Pueblo, CO 81008-2209
Phone
(719) 296-0077
Fax
(719) 595-7408
NPI assigned
Oct 16, 2006
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X AFE69459 CA
Orthopaedic Trauma Physician 207XX0801X DR.0045239 CO
Orthopaedic Surgery Physician 207X00000X 45239 CO Primary

Addresses

Primary practice location

3530 E Spaulding Ave
Pueblo, CO 81008-2209

Mailing address

1338 Phay Ave
Canon City, CO 81212-2311
Phone (719) 285-2647

Other practice location 1

1338 Phay Ave
Canon City, CO 81212
Phone (719) 285-2647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090601000353 CO Practitioner - Orthopedic Surgery 1153416458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1338 Phay Ave
Canon City, CO 81212-2326
Phone (719) 285-2760

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

4112 Outlook Blvd
Pueblo, CO 81008-1667

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement23
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AFE69459CAMDOrthopaedic Surgery Physician
45239COMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Jan 4, 2021 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado Orthopaedic Surgery CurrentSince Jan 4, 2021 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Central Montana Medical Facilities, Inc. Orthopaedic Surgery Past Accepting new patients
Central Montana Medical Facilities, Inc Past Accepting new patients

Locations

4112 Outlook Blvd
Ste 37
Pueblo, CO 81008
Phone (719) 562-6254

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 6

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 5

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1285714402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122311",
            "telephone_number": "719-285-2647",
            "fax_number": "719-595-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 E SPAULDING AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082209",
            "telephone_number": "719-296-0077",
            "fax_number": "719-595-7408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1338 Phay Ave",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "81212",
            "country_code": "US",
            "telephone_number": "719-285-2647",
            "fax_number": "719-285-2646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "AFE69459",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "CO",
            "license": "DR.0045239",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "45239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.