Individual provider Active NPI

Alexander Porto, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1912307158
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA51789 Issued in CA
Practice address
3701 J St Ste 201
Sacramento, CA 95816-5542
Phone
(855) 354-2242
NPI assigned
Aug 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA51789 CA Primary

Addresses

Primary practice location

3701 J St Ste 201
Sacramento, CA 95816-5542

Mailing address

1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484

Other practice location 1

1111 Exposition Blvd Bldg 700
Sacramento, CA 95815-4314
Phone (916) 736-3399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231002015 CA Practitioner - Physician Assistant 6103149901 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA51789CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elica Health Centers Physician Assistant CurrentSince Aug 4, 2020 Accepting new patients
Elica Health Centers CurrentSince Aug 4, 2020 Accepting new patients
Mdstat Urgent Care, Inc Past Accepting new patients

Locations

3701 J St
Ste 201
Sacramento, CA 95816

1860 Howe Ave
Ste 440
Sacramento, CA 95825

1750 Wright St
Ste 1
Sacramento, CA 95825

Interoperability endpoints

  • Direct secure messaging: aporto343208@direct.ochin.org

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": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1912307158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484",
            "fax_number": "916-736-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST STE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "855-354-2242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Exposition Blvd Bldg 700",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958154314",
            "country_code": "US",
            "telephone_number": "916-736-3399",
            "fax_number": "916-736-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTO",
        "first_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA51789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.