Russell Keith Portenoy, M.D.

Primary specialty

Hospice and Palliative Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084H0002X

License

146475 Issued in NY

Practice address

MJHS Hospice and Palliative Care
39 Broadway #R FL
New York, NY 10006

Phone

(212) 649-5560

Fax

(212) 649-5544

NPI assigned

Nov 8, 2005

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Beth Israel Medical Center

  • Pain Medicine Physician
  • New York, NY
  • NPI 1558326702
  NPD (past) Authorized official

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1407837396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MJHS HOSPICE AND PALLIATIVE CARE",
            "address_2": "39 BROADWAY #R FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10006",
            "telephone_number": "212-649-5560",
            "fax_number": "212-649-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MJHS HOSPICE AND PALLIATIVE CARE",
            "address_2": "39 BROADWAY #R FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10006",
            "telephone_number": "212-649-5560",
            "fax_number": "212-649-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTENOY",
        "first_name": "RUSSELL",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "146475",
            "primary": false
        },
        {
            "code": "2084H0002X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "146475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00906634",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Portela
• Joseph Portelli
• Michael Portelli, LCSW
• Joan Katherine Portello, O.D., M.P.H.
• Allison Mille Portenoy, MD
• Natalia Porter-Eisgrub, LMHC
• Barbara A Porter, M.D.
• Emma F Porter, PH.D.
• Evan Jai Porter, RN
• Franklin A Porter, PH.D.

• Hospice and Palliative Medicine (Psychiatry & Neurology) Physician in New York, NY
• Providers in New York, NY by specialty
• Hospice and Palliative Medicine (Psychiatry & Neurology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.