Emily Amanda Porzondek, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704362685 Issued in MI

Practice address

3111 Electric Ave
Port Huron, MI 48060-8127

Phone

(810) 985-8900

NPI assigned

Mar 25, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Revival Recovery Center Staffing LLC

  • Family Nurse Practitioner
  • Highland, MI
  • NPI 1184398331
  Medicare reassignment

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1437951217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50734 WOODBURY DR",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480474391",
            "telephone_number": "586-354-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608127",
            "telephone_number": "810-985-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORZONDEK",
        "first_name": "EMILY",
        "middle_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704362685",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704362685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Port Huron Mercy Family Care Inc
• Port Huron Ophthalmology, PLLC
• Port Huron Pharmacy, LLC
• Port Huron Vascular Clinic PC
• Ramona Dolores Portis, CASE MANAGER-CAC-M
• Jadean Ireland Potter, LMSW
• Damion Powell
• Krystle Preston, LMSW
• Alissa Prevo
• Madison Kylee Priehs

• Psychiatric/Mental Health Nurse Practitioner in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.