Individual provider Active NPI

Ronald Peter Portadin, M.D.

  • Gynecology Physician
  • Mays Landing, NJ
National Provider Identifier
1790770543
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MA02273800 Issued in NJ
Practice address
3980 Black Horse Pike
Mays Landing, NJ 08330-3107
Phone
(609) 625-1600
Fax
(609) 625-2610
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 25MA02273800 NJ Primary

Addresses

Primary practice location

3980 Black Horse Pike
Mays Landing, NJ 08330-3107

Mailing address

PO Box 536
Voorhees, NJ 08043-0536
Phone (856) 669-6050

Other identifiers 1

IdentifierTypeStateIssuer
0277801MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA02273800NJMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Womens Health Group LLC CurrentSince Jun 1, 2010 Accepting new patients
Regional Women'S Health Group, LLC CurrentSince Jun 1, 2010 Accepting new patients
Integrity Anesthesia Group, PC Past Accepting new patients
Regional Women'S Health Group, LLC Past Accepting new patients

Locations

312 Applegarth Rd
Ste 102
Monroe Twp, NJ 08831
Phone (732) 536-5552

188 Fries Mill Rd
Ste N1
Turnersville, NJ 08012
Phone (609) 261-7023

1318 S Main Rd
Vineland, NJ 08360
Phone (856) 691-8585

1318 S Main Rd
Ste 3A
Vineland, NJ 08360
Phone (856) 462-6350

Organizations & group practices 4

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1790770543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 536",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080430536",
            "telephone_number": "856-669-6050",
            "fax_number": "856-651-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 BLACK HORSE PIKE",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083303107",
            "telephone_number": "609-625-1600",
            "fax_number": "609-625-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTADIN",
        "first_name": "RONALD",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA02273800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0277801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mays Landing, NJ

Sources for this page

Verify at the official NPI Registry.