Individual provider Active NPI

Donald Elwood Porter, MD

  • Sports Medicine (Family Medicine) Physician
  • Tucson, AZ
National Provider Identifier
1841325552
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
13521 Issued in AZ
Practice address
1224 East Lowell Street
Tucson, AZ 85721
Phone
(520) 626-5733
Fax
(520) 626-2416
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 13521 AZ Primary

Addresses

Primary practice location

1224 East Lowell Street
Tucson, AZ 85721

Mailing address

5387 E River Rd
Tucson, AZ 85718-7247
Phone (520) 529-1908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20070604000597 AZ Practitioner - Family PracticePractitioner - Other (Physician) 6709984412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13521AZMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jun 1, 2007 Accepting new patients
Banner-University Medical Group Family Medicine CurrentSince Jun 1, 2007 Accepting new patients
The University of Arizona, Campus Health Service Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2800 E Ajo Way
Bldg 200
Tucson, AZ 85713
Phone (520) 874-2000

2800 E Ajo Way
Ste 200
Tucson, AZ 85713
Phone (520) 462-0248

1501 N Campbell Ave
#245575
Tucson, AZ 85724

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841325552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5387 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857187247",
            "telephone_number": "520-529-1908",
            "fax_number": "520-626-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 EAST LOWELL STREET",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85721",
            "telephone_number": "520-626-5733",
            "fax_number": "520-626-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DONALD",
        "middle_name": "ELWOOD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "13521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.