Maria Kezia Lourdes Ligsay Pormento, MD, MBA

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1431 N Western Ave Ste 406
Chicago, IL 60622-1774

Phone

(312) 633-5841

Fax

(312) 491-5020

NPI assigned

Apr 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: maria.kezia.lourdes.pormento.1@16494.direct.athenahealth.com

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1881380004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221774",
            "telephone_number": "312-633-5841",
            "fax_number": "312-491-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221774",
            "telephone_number": "312-633-5841",
            "fax_number": "312-491-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORMENTO",
        "first_name": "MARIA KEZIA LOURDES",
        "middle_name": "LIGSAY",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "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": []
}

• Margherita Porcella, LPC
• Timothy W Porcelli, LCPED
• Ebone Porch
• Ravali Poreddy, MD
• Suzanne E Porfyris, NP
• Nery Porras, M.D.
• Janice Ivette Porrata
• Arielle Port, MD
• Emily Porta
• Nicolas FM Porta, MD

• Student in an Organized Health Care Education/Training Program in Chicago, IL
• Providers in Chicago, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.