Individual provider Active NPI

Edna Kathleen Porter, MD

  • Maternal & Fetal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1720027535
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
ME50841 Issued in FL
Practice address
16261 Bass Rd
Fort Myers, FL 33908-3671
Phone
(239) 481-5477
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X ME50841 FL Primary
Obstetrics & Gynecology Physician 207V00000X ME50841 FL

Addresses

Primary practice location

16261 Bass Rd
Fort Myers, FL 33908-3671

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843
Phone (800) 243-3839

Other names 1

  • Dr. Edna Kathleen Porter Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Mednax Health Information Exchange (HIE) Mednax

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210920001898 FL Practitioner - Obstetrics/Gynecology 8921182197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Alabama College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (561) 515-1500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME50841FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Aug 1, 2024 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Obstetrics & Gynecology CurrentSince Aug 1, 2024 Accepting new patients
University of South Alabama Health Services Foundation Past Accepting new patients
University of Miami Past Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
#4070
Miami, FL 33136
Phone (305) 243-4960

8932 SW 97th Ave
Ste L
Miami, FL 33176
Phone (239) 659-3937

8932 SW 97th Ave
Miami, FL 33176
Phone (305) 270-3485

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1611 NW 12th Ave
Ste 600B
Miami, FL 33136
Phone (305) 355-1303

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: eporter139532@direct.med.miami.edu

Organizations & group practices 5

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1720027535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "800-243-3839",
            "fax_number": "251-470-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16261 BASS RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083671",
            "telephone_number": "239-481-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "EDNA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "FL",
            "license": "ME50841",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME50841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Mednax",
            "affiliation": "Y",
            "endpointDescription": "mednax",
            "affiliationName": "Mednax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1600 S Andrews Ave",
            "city": "Ft Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333162510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EDNA",
            "last_name": "PORTER",
            "middle_name": "KATHLEEN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.