Individual provider Active NPI

Elaine Ports, P.A.

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1487718516
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C03427 Issued in MD
Practice address
5601 Loch Raven Blvd
Pob Suite G1
Baltimore, MD 21239-2905
Phone
(410) 532-4735
Fax
(410) 532-4752
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C03427 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Pob Suite G1
Baltimore, MD 21239-2905

Mailing address

5601 Loch Raven Blvd
Pob Suite G1
Baltimore, MD 21239-2905
Phone (410) 532-4735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20070302000086 MD Practitioner - Physician Assistant 5698877090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Plastic Surgery P CGroup PAC ID 2769469097, 7 clinicians

Practice addresses (Care Compare)

314 W Carroll St
Suite 1
Salisbury, MD 21801-5409
Phone (410) 546-0464

Hospital & facility affiliations

  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C03427MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Plastic Surgery P.C. CurrentSince Aug 1, 2023 Accepting new patients
Saint Paul Place Specialists, Inc. CurrentSince Mar 22, 2013 Accepting new patients
St Paul Place Specialists Inc CurrentSince Mar 22, 2013 Accepting new patients
Saint Paul Place Specialists, Inc. Past Accepting new patients
The Good Samaritan Hospital of Maryland Inc Past Accepting new patients
Medstar Harbor Hospital Physicians LLC Past Accepting new patients
Harbor Hospital Past Accepting new patients
Peninsula Plastic Surgery P C Past Accepting new patients
The Good Samaritan Hospital of Maryland Inc Past Accepting new patients

Locations

30265 Commerce Dr
Unit 208
Millsboro, DE 19966
Phone (302) 663-0119

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

124 N Main St
Ste D
Berlin, MD 21811
Phone (410) 546-0464

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

314 W Carroll St
Ste 1
Salisbury, MD 21801
Phone (410) 546-0464

Organizations & group practices 10

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 1

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487718516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "POB SUITE G1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4735",
            "fax_number": "410-532-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "POB SUITE G1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4735",
            "fax_number": "410-532-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTS",
        "first_name": "ELAINE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C03427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.