NPIMap

Individual provider Active NPI

Brent A Porter, MD

  • Internal Medicine Physician
  • Bastrop, TX
National Provider Identifier
1588680672
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L1969 Issued in TX
Practice address
441 Highway 71 W
Suite C
Bastrop, TX 78602-3931
Phone
(512) 304-0313
Fax
(512) 304-0326
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L1969 TX Primary

Addresses

Primary practice location

441 Highway 71 W
Suite C
Bastrop, TX 78602-3931

Mailing address

1601 Rio Grande St
Suite 340
Austin, TX 78701-1137
Phone (512) 324-8960

Other identifiers 1

IdentifierTypeStateIssuer
145173408MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323000592 TX Practitioner - Internal Medicine 8022909738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension SetonGroup PAC ID 5193634293, 54 clinicians

Practice addresses (Care Compare)

630 Hwy 71 W
Suite E
Bastrop, TX 78602-4234
Phone (512) 304-0313

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors Internal Medicine Current Accepting new patients
Ascension Seton CurrentSince Feb 6, 2019 Accepting new patients
Seton Family of Doctors Internal Medicine CurrentSince Feb 1, 2014 Accepting new patients
Ascension Seton Internal Medicine CurrentSince Feb 6, 2019 Accepting new patients
Seton Family of Doctors CurrentSince Feb 1, 2014 Accepting new patients
Seton Family of Hospitals Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients

Locations

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

4616 W Howard Ln
Austin, TX 78728
Phone (224) 558-8613

441 Highway 71 W
#C
Bastrop, TX 78602
Phone (512) 304-0313

630 W State Highway 71
Ste E
Bastrop, TX 78602
Phone (512) 304-0313

441 Highway 71 W
Ste C
Bastrop, TX 78602
Phone (512) 301-0313

630 W State Highway 71
Bastrop, TX 78602
Phone (737) 881-7400

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

130 Hays St
Ste Bd
Luling, TX 78648
Phone (830) 875-7000

605 NE 9th St
Smithville, TX 78957
Phone (512) 237-2411

Interoperability endpoints

  • Direct secure messaging: brent.porter.2@8363.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ascension Seton Bastrop Health CenterBastrop, TX, CCN 673470 Rural health clinic Operational/Managerial Control Dec 20, 2016
Ascension Seton Smithville Health CenterSmithville, TX, CCN 673469 Rural health clinic W-2 Managing Employee Dec 20, 2016
Ascension Seton Elgin Health CenterElgin, TX, CCN 673484 Rural health clinic Operational/Managerial Control Dec 20, 2016

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 8

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1588680672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 RIO GRANDE ST",
            "address_2": "SUITE 340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011137",
            "telephone_number": "512-324-8960",
            "fax_number": "512-324-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 HIGHWAY 71 W",
            "address_2": "SUITE C",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023931",
            "telephone_number": "512-304-0313",
            "fax_number": "512-304-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "BRENT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L1969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145173408",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

Verify at the official NPI Registry.