Individual provider Active NPI

Joseph M Porres, MD

  • Dermatology Physician
  • Rockville, MD
National Provider Identifier
1902835689
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D44137 Issued in MD
Practice address
50 W Edmonston Dr
308
Rockville, MD 20852
Phone
(301) 762-7364
Fax
(301) 762-7382
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D44137 MD Primary
Dermatopathology Physician 207ND0900X D44137 MD
Procedural Dermatology Physician 207NS0135X D44137 MD

Addresses

Primary practice location

50 W Edmonston Dr
308
Rockville, MD 20852

Mailing address

50 W Edmonston Dr
308
Rockville, MD 20852
Phone (301) 762-7364

Other identifiers 1

IdentifierTypeStateIssuer
423500200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20090923000049 DC Practitioner - DermatologyPractitioner - Pathology 4183770720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 W Edmonston Dr
Suite 308
Rockville, MD 20852-1276
Phone (301) 762-7364

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of tissue1-10
Removal of skin lesions92
Removal of nail tissue1-10
Skin biopsy32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D44137MDMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Porres MD PC Dermatology CurrentSince Dec 19, 2010 Accepting new patients

Locations

50 W Edmonston Dr
Ste 308
Rockville, MD 20852
Phone (301) 762-7364

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1902835689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W EDMONSTON DR",
            "address_2": "308",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-762-7364",
            "fax_number": "301-762-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W EDMONSTON DR",
            "address_2": "308",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-762-7364",
            "fax_number": "301-762-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRES",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D44137",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MD",
            "license": "D44137",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MD",
            "license": "D44137",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423500200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.