Individual provider Active NPI

Edwin Porres, M.D.

  • Emergency Medicine Physician
  • Huntington, WV
National Provider Identifier
1639376593
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12856 Issued in WV
Practice address
1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone
(304) 526-2200
Fax
(304) 399-1507
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12856 WV
Emergency Medicine Physician 207P00000X 12856 WV Primary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 12856 WV

Addresses

Primary practice location

1340 Hal Greer Blvd
Huntington, WV 25701-3804

Mailing address

1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone (304) 526-2200

Other identifiers 4

IdentifierTypeStateIssuer
1639376593MedicaidWV
64694524MedicaidKY
930050958OtherWVMEDICARE-RR PROVIDER NUMBER
0479101MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edwin.porres@direct.chhi.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100317000041 WV Practitioner - Emergency MedicinePractitioner - Internal Medicine 1951436906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cabell Huntington Hospital IncGroup PAC ID 3274436340, 88 clinicians

Practice addresses (Care Compare)

1340 Hal Greer Blvd
Huntington, WV 25701-3800
Phone (304) 399-2960

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cabell Huntington Hospital Inc Current Accepting new patients
Cabell Huntington Hospital Inc Internal Medicine Past Accepting new patients

Locations

1340 Hal Greer Blvd
Fl 4
Huntington, WV 25701
Phone (304) 526-6387

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

Organizations & group practices 2

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1639376593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013804",
            "telephone_number": "304-526-2200",
            "fax_number": "304-399-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013804",
            "telephone_number": "304-526-2200",
            "fax_number": "304-399-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRES",
        "first_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "12856",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "12856",
            "primary": true
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "WV",
            "license": "12856",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639376593",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64694524",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-RR PROVIDER NUMBER",
            "identifier": "930050958",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0479101",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edwin.porres@direct.chhi.org",
            "affiliation": "N",
            "address_1": "1340 Hal Greer Blvd",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.