Individual provider Active NPI

Renee Porter, P.A.

  • Surgical Physician Assistant
  • Buffalo, NY
National Provider Identifier
1922045210
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
010940-1 Issued in NY
Practice address
565 Abbott Rd
Buffalo, NY 14220
Phone
(716) 826-7000
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 010940-1 NY Primary

Addresses

Primary practice location

565 Abbott Rd
Buffalo, NY 14220

Mailing address

440 Beebe Rd
Ilion, NY 13357-3741
Phone (315) 897-6694

Other identifiers 1

IdentifierTypeStateIssuer
02743259MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051206000201 NY Practitioner - Physician Assistant 9032139324 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital of BuffaloGroup PAC ID 8729991666, 198 clinicians

Practice addresses (Care Compare)

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 826-7000

Hospital & facility affiliations

  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010940-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount St. Mary'S Hospital of Niagara Falls CurrentSince Nov 1, 2020 Accepting new patients
Albany Medical College CurrentSince Jul 26, 2016 Accepting new patients
Kenmore Mercy Hospital CurrentSince Nov 1, 2020 Accepting new patients
Albany Medical College Current Accepting new patients
Mercy Hospital of Buffalo CurrentSince Dec 1, 2018 Accepting new patients
Albany Medical College CurrentSince Jul 26, 2016 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Mount St. Mary'S Hospital of Niagara Falls CurrentSince Nov 1, 2020 Accepting new patients
Eastern Great Lakes Pathology PC Current Accepting new patients
Albany Medical College Current Accepting new patients
Mercy Hospital of Buffalo CurrentSince Dec 1, 2018 Accepting new patients
Sisters of Charity Hospital of Buffalo, New York Current Accepting new patients
Mohawk Valley Surgery Group Past Accepting new patients

Locations

50 New Scotland Ave
Fl 3
Albany, NY 12208
Phone (518) 262-5864

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

515 Abbott Rd
Ste 310
Buffalo, NY 14220
Phone (716) 332-3505

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1922045210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 BEEBE RD",
            "city": "ILION",
            "state": "NY",
            "postal_code": "133573741",
            "telephone_number": "315-897-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ABBOTT RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14220",
            "telephone_number": "716-826-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "RENEE",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "010940-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02743259",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.