Active NPI
Lidia Portan
- Case Manager/Care Coordinator
- Glendale, AZ
National Provider Identifier
1407024383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- ALH-6526
- Practice address
- 6559 W Pinnacle Peak Rd
Glendale, AZ 85310-3415 - Phone
- (623) 376-6134
- NPI assigned
- Feb 13, 2008
- Last updated
- Feb 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | ALH-6526 | AZ | Primary |
Addresses
Primary practice location
6559 W Pinnacle Peak Rd
Glendale, AZ 85310-3415
Mailing address
6559 W Pinnacle Peak Rd
Glendale, AZ 85310-3415
Phone (623) 376-6134
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ALH-6526 | Other | AZ | AZ DHS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ALH-6526 | AZ | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1407024383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6559 W PINNACLE PEAK RD",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853103415",
"telephone_number": "623-376-6134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6559 W PINNACLE PEAK RD",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853103415",
"telephone_number": "623-376-6134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTAN",
"first_name": "LIDIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-13",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "AZ",
"license": "ALH-6526",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ DHS",
"identifier": "ALH-6526",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.