Individual provider Active NPI

Megan K Porth, NP-C

  • Family Nurse Practitioner
  • Park Ridge, IL
National Provider Identifier
1700631074
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209029104 Issued in IL
Practice address
1700 Luther LN FL Center3
Park Ridge, IL 60068-1270
Phone
(847) 723-3100
Fax
(847) 722-3326
NPI assigned
Apr 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209029104 IL Primary
Registered Nurse 163W00000X 041450880 IL

Addresses

Primary practice location

1700 Luther LN FL Center3
Park Ridge, IL 60068-1270

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

7201 Nighthawk Way
Cary, IL 60013-6056
Phone (815) 861-0409

Other names 1

  • Megan K Ulmanis Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mulmanis233620@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025000551 IL Practitioner - Nurse Practitioner 3476086711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 Luther LN
Park Ridge, IL 60068-1270

1775 Dempster St
Park Ridge, IL 60068-1143

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041450880ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation CurrentSince Sep 12, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 12, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

1700 Luther Ln
#3
Park Ridge, IL 60068
Phone (847) 723-3100

1700 Luther Ln
Fl 3
Park Ridge, IL 60068
Phone (414) 732-9399

Organizations & group practices 3

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 5

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": "1713571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1700631074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 LUTHER LN FL CENTER3",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681270",
            "telephone_number": "847-723-3100",
            "fax_number": "847-722-3326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7201 Nighthawk Way",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "IL",
            "postal_code": "600136056",
            "country_code": "US",
            "telephone_number": "815-861-0409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTH",
        "first_name": "MEGAN",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-20",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209029104",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041450880",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mulmanis233620@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 Luther Ln Fl Center3",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1700 Luther Ln Fl Center3",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "ULMANIS",
            "middle_name": "K",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.