NPIMap

Individual provider Active NPI

Kathleen Pormento

  • Physician Assistant
  • Hackensack, NJ
National Provider Identifier
1306213343
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00372200 Issued in NJ
Practice address
92 2ND St
Hackensack, NJ 07601-2191
Phone
(551) 996-5855
NPI assigned
Aug 25, 2015
Last updated
Apr 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY
Physician Assistant 363A00000X 25MP00372200 NJ Primary

Addresses

Primary practice location

92 2ND St
Hackensack, NJ 07601-2191

Mailing address

130 Sutter St FL 2
San Francisco, CA 94104-4009
Phone (415) 658-6791

Other practice location 1

50 Pompton Ave
Verona, NJ 07044-2917
Phone (973) 857-3400

Other practice location 2

794 Union St
Brooklyn, NY 11215-1307
Phone (212) 624-1077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181231001119 NY Practitioner - Physician Assistant 4587909155 Reassigns benefits to 4 organizations
I20200414001658 NJ Practitioner - Physician Assistant 4587909155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mskcc Clinical Practice PlanGroup PAC ID 4981704541, 84 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

530 E 74TH St
New York, NY 10021-3402
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.57 of 100Reported as group
Quality
70.48
Improvement activities
40
Cost
69.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cancer Care Associates LLC CurrentSince Mar 9, 2020 Accepting new patients
Mount Sinai School of Medicine CurrentSince Feb 9, 2019 Accepting new patients
Mskcc Clinical Practice Plan CurrentSince Sep 16, 2023 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Mar 9, 2020 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince May 12, 2021 Accepting new patients
One Medical of Ny, P.C. Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

92 2nd St
Hackensack, NJ 07601
Phone (551) 996-2210

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: kpormentomendoza27124@mskcc.direct-ci.com

Organizations & group practices 7

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 11

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1306213343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 2ND ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012191",
            "telephone_number": "551-996-5855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Pompton Ave",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070442917",
            "country_code": "US",
            "telephone_number": "973-857-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "794 Union St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112151307",
            "country_code": "US",
            "telephone_number": "212-624-1077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORMENTO",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00372200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.