Individual provider Active NPI

Stacy Porter

  • Emergency Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1962601856
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
43003 Issued in AZ
Practice address
7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone
(248) 898-5000
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 43003 AZ Primary

Addresses

Primary practice location

7400 E Osborn Rd
Scottsdale, AZ 85251-6432

Mailing address

PO Box 2808
Scottsdale, AZ 85252-2808

Other identifiers 1

IdentifierTypeStateIssuer
43003OtherAZARIZONA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100922001026 AZ Practitioner - Emergency Medicine 6204952690 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43003AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Emergency Associates, LTD. Emergency Medicine CurrentSince Oct 1, 2011 Accepting new patients
Honorhealth Emergency Medicine CurrentSince Aug 7, 2023 Accepting new patients
Honorhealth CurrentSince Aug 7, 2023 Accepting new patients
Scottsdale Emergency Associates, LTD. Emergency Medicine Current Accepting new patients

Locations

4545 N Hunt Hwy
Florence, AZ 85132
Phone (480) 258-6100

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

16575 W Waddell Rd
Surprise, AZ 85388
Phone (623) 300-9110

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1962601856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2808",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852522808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516432",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "43003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL LICENSE",
            "identifier": "43003",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.