Marvin M Portner, M.D.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

MD87328 Issued in SC

Practice address

1783 Shell Ring Cir
Mount Pleasant, SC 29466-8030

Phone

(310) 266-3050

Fax

(310) 454-5318

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2015 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Portner Medical PC

  • Allergy Physician
  • Mount Pleasant, SC
  • NPI 1235162850
  NPD Authorized official

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1356366793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 SHELL RING CIR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294668030",
            "telephone_number": "310-266-3050",
            "fax_number": "310-454-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 SHELL RING CIR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294668030",
            "telephone_number": "310-266-3050",
            "fax_number": "310-454-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTNER",
        "first_name": "MARVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "C28757",
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "SC",
            "license": "MD87328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF SOUTH CAROLINA",
            "identifier": "MD87328",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Porpora
• Port City Ambulance Service LLC
• Polly Porter-Campbell, RN
• Ryan William Porter, DPT
• Portner Medical PC
• Toya Pound, MD
• Elizabeth Lauren Powell, PA
• Sandra L Powell, MD
• PPCP Specialty Physicians , LLC
• Preferred Eyecare Center, LLC

• Allergy Physician in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Allergy Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.