Active NPI
Minto K Porter, MD
- Allergy & Immunology Physician
- Brainerd, MN
National Provider Identifier
1790776623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 46609
- Practice address
- 2024 S 6TH St
Brainerd, MN 56401-4529 - Phone
- (218) 828-7100
- Fax
- (218) 828-7194
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 46609 | MN | |
| Allergy & Immunology Physician | 207K00000X | 46609 | MN | Primary |
Addresses
Primary practice location
2024 S 6TH St
Brainerd, MN 56401-4529
Mailing address
523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1202864 | Other | MEDICA HEALTH PLANS | |
| 315M2PO | Other | BLUE CROSS BLUE SHIELD | |
| 1041076 | Other | PREFERRED ONE | |
| 131482 | Other | U CARE | |
| 2121655 | Other | ARAZ GROUP | |
| 183492400 | Other | MEDICAL ASSISTANCE | |
| HP42090 | Other | HEALTH PARTNERS | |
| 2197249 | Other | FIRST HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- University of North Dakota School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1511 Northway Dr
Suite 101
Saint Cloud, MN 56303-1262
Phone (320) 654-8266
Hospital & facility affiliations
- Centracare - St. Cloud Hospital
- Essentia Health St Joseph'S Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Minnesota Allergy and Asthma | Current | Accepting new patients |
Locations
1511 Northway Dr
Ste 101
Saint Cloud, MN 56303
Phone (320) 654-8266
Interoperability endpoints
- mporter1511@direct.centracare.com
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.
-
- Allergy Physician
- Saint Cloud, MN
- NPI 1821815697
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Saint Cloud, MN
- NPI 1811150618
-
- General Acute Care Hospital
- Saint Cloud, MN
- NPI 1043269798
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Saint Cloud, MN
- NPI 1467615294
-
- General Acute Care Hospital
- Saint Cloud, MN
- NPI 1841502929
-
- Psychiatric Hospital Unit
- Saint Cloud, MN
- NPI 1932419058
-
- General Acute Care Hospital
- Brainerd, MN
- NPI 1568415974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1790776623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 N 3RD ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564013054",
"telephone_number": "218-829-2861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2024 S 6TH ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564014529",
"telephone_number": "218-828-7100",
"fax_number": "218-828-7194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "MINTO",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-31",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "46609",
"primary": false
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "MN",
"license": "46609",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HEALTH PLANS",
"identifier": "1202864",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "315M2PO",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1041076",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE",
"identifier": "131482",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ GROUP",
"identifier": "2121655",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "183492400",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP42090",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH PLAN",
"identifier": "2197249",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Brainerd, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.