NPIMap

Individual provider Active NPI

Samuel Jaime Porter, M.D.

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1366500209
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A22916 Issued in CA
Practice address
321 N Larchmont Blvd
Suite 618
Los Angeles, CA 90004-6406
Phone
(323) 469-7133
Fax
(323) 469-7150
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A22916 CA Primary

Addresses

Primary practice location

321 N Larchmont Blvd
Suite 618
Los Angeles, CA 90004-6406

Mailing address

321 N Larchmont Blvd
Suite 618
Los Angeles, CA 90004-3025
Phone (323) 469-7133

Other identifiers 1

IdentifierTypeStateIssuer
00A229160MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110214000899 CA Practitioner - Obstetrics/Gynecology 6608056254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, Irvine, California College of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

321 N Larchmont Blvd
Suite 618
Los Angeles, CA 90004-6406
Phone (323) 469-7133

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A22916CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel J. Porter, M.D., a Medical Corporation Obstetrics & Gynecology CurrentSince Apr 13, 1978 Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Dignity Community Care Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

321 N Larchmont Blvd
Ste 618
Los Angeles, CA 90004
Phone (213) 469-7133

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1366500209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N LARCHMONT BLVD",
            "address_2": "SUITE 618",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043025",
            "telephone_number": "323-469-7133",
            "fax_number": "323-469-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N LARCHMONT BLVD",
            "address_2": "SUITE 618",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900046406",
            "telephone_number": "323-469-7133",
            "fax_number": "323-469-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "SAMUEL",
        "middle_name": "JAIME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A22916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A229160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.