Individual provider Active NPI

Whitney Aislinn Porter, PA-C

  • Medical Physician Assistant
  • San Jose, CA
National Provider Identifier
1780038091
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
53352 Issued in CA
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-5111
NPI assigned
Apr 22, 2016
Last updated
Apr 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 53352 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

100 N Whisman Rd
#1611
Mountain View, CA 94043-4952
Phone (408) 540-8713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240910003199 OR Practitioner - Physician Assistant 9830471895 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53352CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Acute Care Specialists PC CurrentSince Nov 1, 2024 Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1780038091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N WHISMAN RD",
            "address_2": "#1611",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940434952",
            "telephone_number": "408-540-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "WHITNEY",
        "middle_name": "AISLINN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.