Individual provider Active NPI

John Portelli III, MD FACC

  • Cardiovascular Disease Physician
  • Poughkeepsie, NY
National Provider Identifier
1710950779
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
202710 Issued in NY
Practice address
1 Columbia St
Suite 200
Poughkeepsie, NY 12601
Phone
(845) 473-1188
Fax
(845) 473-0896
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 202710 NY Primary
Nuclear Cardiology Physician 207UN0901X 202710 NY

Addresses

Primary practice location

1 Columbia St
Suite 200
Poughkeepsie, NY 12601

Mailing address

1 Columbia St
Suite 200
Poughkeepsie, NY 12601-3923
Phone (845) 473-1188

Other identifiers 1

IdentifierTypeStateIssuer
01661509MedicaidNY

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
I20100304000279 NY Practitioner - Cardiovascular Disease (Cardiology) 4385733450

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio State University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Columbia St
Suite 200
Poughkeepsie, NY 12601-3923

1 Columbia St
Suite 200
Poughkeepsie, NY 12601-3924

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.69 of 100Reported as group
Quality
54.12
Promoting interoperability
98
Improvement activities
40
Cost
76.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202710NYMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Valley Cardiovascular Practice, PC Cardiovascular Disease CurrentSince Nov 4, 2013 Accepting new patients

Locations

939 Little Britain Rd
New Windsor, NY 12553
Phone (845) 291-7041

1 Columbia St
Poughkeepsie, NY 12601
Phone (845) 473-1188

1 Columbia St
Ste 300
Poughkeepsie, NY 12601
Phone (845) 483-0100

1 Columbia St
Ste 200
Poughkeepsie, NY 12601
Phone (845) 473-1188

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1710950779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLUMBIA ST",
            "address_2": "SUITE 200",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013923",
            "telephone_number": "845-473-1188",
            "fax_number": "845-473-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLUMBIA ST",
            "address_2": "SUITE 200",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-473-1188",
            "fax_number": "845-473-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTELLI",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD FACC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "202710",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NY",
            "license": "202710",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01661509",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.