Jeanette Marie Porter, PHYSICIAN ASSISTANT

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00223600 Issued in NJ

Practice address

540 Lafayette Rd
Suite D
Sparta, NJ 07871-3497

Phone

(973) 300-1553

Fax

(973) 383-6236

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jeanette Marie Powers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Stephen E. Hatfield, DO LLC

  dba East Mesa Orthopedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Mesa, AZ
  • NPI 1548457203
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1679662480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 LAFAYETTE RD",
            "address_2": "SUITE D",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713497",
            "telephone_number": "973-300-1553",
            "fax_number": "973-383-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LAFAYETTE RD",
            "address_2": "SUITE D",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713497",
            "telephone_number": "973-300-1553",
            "fax_number": "973-383-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JEANETTE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3500",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3500",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00223600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTE",
            "last_name": "POWERS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Pirnos
• David Pisani, R.N.
• Maria Pisani, LPC, LCADC
• Philip John Pistolas, DDS
• Dawn M Poli, D.M.D.
• Maryann Lane Porter, MSW, LCSW
• Powerback Rehabilitation LLC (Powerback Rehabilitation)
• Precision Dental Sleep Therapy LLC
• Premier Health Associates, LLC
• Primary Care Partners LLC (Skylands Pediatrics-Primary Care Partners Affiliate)

• Surgical Physician Assistant in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.