Individual provider Active NPI

Tamar Judith Port, MSS

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1710975834
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW000153L Issued in PA
Practice address
1420 Locust St Apt 34K
Philadelphia, PA 19102-4222
Phone
(215) 530-2564
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW000153L PA Primary

Addresses

Primary practice location

1420 Locust St Apt 34K
Philadelphia, PA 19102-4222

Mailing address

1420 Locust St Apt 34K
Philadelphia, PA 19102-4222
Phone (215) 530-2564

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000580 PA Practitioner - Clinical Social Worker 9133134596 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Philadelphia, PA 19102
Phone (215) 530-2564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tamar Port Counseling LLC Clinical PastSince May 22, 2015 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1710975834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 LOCUST ST APT 34K",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024222",
            "telephone_number": "215-530-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LOCUST ST APT 34K",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024222",
            "telephone_number": "215-530-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORT",
        "first_name": "TAMAR",
        "middle_name": "JUDITH",
        "name_prefix": "Mrs.",
        "credential": "MSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW000153L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.