Individual provider Active NPI

David F Porter, D.O.

  • Family Medicine Physician
  • Hasbrouck Heights, NJ
National Provider Identifier
1588673180
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB036740 Issued in NJ
Practice address
208 Boulevard
Hasbrouck Heights, NJ 07604
Phone
(201) 288-0872
Fax
(201) 288-8180
NPI assigned
Aug 5, 2006
Last updated
Jul 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB036740 NJ Primary

Addresses

Primary practice location

208 Boulevard
Hasbrouck Heights, NJ 07604

Mailing address

208 Boulevard
Hasbrouck Heights, NJ 07604
Phone (201) 288-0872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080930000594 NJ Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 2163599333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Michigan State University College of Osteopathic Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

208 Boulevard
F
Hasbrouck Heights, NJ 07604-1839
Phone (201) 288-0872

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MB036740NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David F Porter D.O., P.a. Family Medicine CurrentSince Jul 22, 2008 Accepting new patients

Locations

208 Boulevard
Hasbrouck Heights, NJ 07604
Phone (201) 288-0872

208 Boulevard
Ste F
Hasbrouck Heights, NJ 07604
Phone (201) 288-0872

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1588673180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BOULEVARD",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "07604",
            "telephone_number": "201-288-0872",
            "fax_number": "201-288-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 BOULEVARD",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "07604",
            "telephone_number": "201-288-0872",
            "fax_number": "201-288-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DAVID",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB036740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hasbrouck Heights, NJ

Sources for this page

Verify at the official NPI Registry.