Individual provider Active NPI

Adam M Deporter, PA-C

  • Physician Assistant
  • Salisbury, MD
National Provider Identifier
1952810020
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C06594 Issued in MD
Practice address
100 E Carroll St
Salisbury, MD 21801-5422
Phone
(410) 546-6400
NPI assigned
Sep 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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 C06594 MD Primary

Addresses

Primary practice location

100 E Carroll St
Salisbury, MD 21801-5422

Mailing address

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 543-7536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20171207003022 MD Practitioner - Physician Assistant 0244597771 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians
Ability Rehab AssociatesGroup PAC ID 4284699406, 9 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

220 Tilghman Rd
Salisbury, MD 21804-1921
Phone (410) 219-5530

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.92 of 100Reported as group
Quality
74.47
Promoting interoperability
92
Improvement activities
40
Cost
75.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C06594MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Peninsula Regional, Inc. Physician Assistant CurrentSince Nov 13, 2017 Accepting new patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Nov 13, 2017 Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

100 E Carroll St
#400
Salisbury, MD 21801
Phone (410) 219-5530

Organizations & group practices 5

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.

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": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1952810020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7536",
            "fax_number": "410-543-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-546-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPORTER",
        "first_name": "ADAM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.