Individual provider Active NPI

Hayden Edward Porter

  • Student in an Organized Health Care Education/Training Program
  • Oceanside, CA
National Provider Identifier
1790364461
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1822 S Clementine St
Oceanside, CA 92054-6013
Phone
(760) 224-9277
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1822 S Clementine St
Oceanside, CA 92054-6013

Mailing address

1822 S Clementine St
Oceanside, CA 92054-6013
Phone (760) 224-9277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260617002256 CA Practitioner - Diagnostic Radiology 8325510654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

File
Suite 57326
Los Angeles, CA 90074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1790364461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 S CLEMENTINE ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546013",
            "telephone_number": "760-224-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 S CLEMENTINE ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546013",
            "telephone_number": "760-224-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "HAYDEN",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.