NPIMap

Individual provider Active NPI

Charles A Portera Jr., MD

  • Surgical Oncology Physician
  • Anchorage, AK
National Provider Identifier
1467412734
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
6982 Issued in AK
Practice address
3851 Piper St Ste U230
Anchorage, AK 99508-6901
Phone
(907) 868-2075
Fax
(907) 312-5882
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 6982 AK Primary

Addresses

Primary practice location

3851 Piper St Ste U230
Anchorage, AK 99508-6901

Mailing address

3851 Piper St Ste U230
Anchorage, AK 99508-6901
Phone (907) 868-2075

Other identifiers 1

IdentifierTypeStateIssuer
151809MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141028000149 AK Practitioner - Surgical Oncology 0042109977 Reassigns benefits to 3 organizations
I20191008003154 TX Practitioner - General Surgery 0042109977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alaska Surgical Group LLCGroup PAC ID 7012250103, 2 clinicians

Practice addresses (Care Compare)

3851 Piper St
Suite U230
Anchorage, AK 99508-6901
Phone (907) 868-2075

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Merit-based Incentive Payment System (MIPS)

Final score
66.21 of 100Reported as group
Quality
36.1
Improvement activities
40
Cost
72.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision41
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6982AKMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Trauma & Acute Care Surgery, LLC CurrentSince Feb 2, 2015 Accepting new patients
Alaska Surgical Group, LLC Surgical Oncology CurrentSince Nov 15, 2018 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Sep 11, 2019 Accepting new patients
Alaska Surgical Oncology LLC Surgical Oncology Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

3851 Piper St
Ste U230
Anchorage, AK 99508
Phone (907) 868-2075

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

3220 Providence Dr
Ste E3-080
Anchorage, AK 99508
Phone (907) 375-8785

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281

Organizations & group practices 6

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 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1467412734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 PIPER ST STE U230",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995086901",
            "telephone_number": "907-868-2075",
            "fax_number": "907-312-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 PIPER ST STE U230",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995086901",
            "telephone_number": "907-868-2075",
            "fax_number": "907-312-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTERA",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "AK",
            "license": "6982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151809",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.