Individual provider Active NPI

Jeffrey Porte, M.D.

  • Obstetrics & Gynecology Physician
  • Setauket, NY
National Provider Identifier
1659591808
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
158367 Issued in NY
Practice address
200 Main Street
Suite 2
Setauket, NY 11733
Phone
(631) 751-9595
Fax
(631) 751-2322
NPI assigned
Apr 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 158367 NY Primary

Addresses

Primary practice location

200 Main Street
Suite 2
Setauket, NY 11733

Mailing address

45 Research Way Ste 105
East Setauket, NY 11733-6401
Phone (631) 675-2125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040719000269 NY Practitioner - Obstetrics/Gynecology 9537147392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Washington School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8091
Phone (631) 444-7650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158367NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Associates in Obstetrics & Gynecology, University Faculty P Obstetrics & Gynecology CurrentSince Jul 1, 2018 Accepting new patients

Locations

774 Sycamore Ave
Ste A
Bohemia, NY 11716
Phone (631) 218-9595

333 Route 25A
Ste 30
Rocky Point, NY 11778
Phone (631) 821-4444

200 Main St
Ste 2
Setauket, NY 11733
Phone (631) 751-9494

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jeffery.porte@sbcm.cernerdirect.com

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": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1659591808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 105",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN STREET",
            "address_2": "SUITE 2",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-751-9595",
            "fax_number": "631-751-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTE",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "158367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Setauket, NY

Sources for this page

Verify at the official NPI Registry.