Andrea S. Porto, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MB06634300 Issued in NJ

Practice address

1125 Atlantic Ave
Atlantic City, NJ 08401

Phone

(609) 348-0066

Fax

(609) 348-1157

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Andrea S. Palermo Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Southern Jersey Family Medical Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Hammonton, NJ
  • NPI 1568473973
  Medicare reassignment NPD
• Southern Jersey Family Medical Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Atlantic City, NJ
  • NPI 1598939506
  NPD
• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  NPD (past)
• Southern Jersey Family Medical Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Egg Harbor Township, NJ
  • NPI 1891222923
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1972687085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080536309",
            "telephone_number": "609-567-0200",
            "fax_number": "609-704-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 ATLANTIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "08401",
            "telephone_number": "609-348-0066",
            "fax_number": "609-348-1157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Atlanticare Regional Medical Center",
            "address_2": "Jimmie Leeds Road",
            "address_purpose": "LOCATION",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409104",
            "country_code": "US",
            "telephone_number": "609-641-3700",
            "fax_number": "609-748-5988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTO",
        "first_name": "ANDREA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "MB06634300",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB06634300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02588172",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7666021",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001776870",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8255300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "PALERMO",
            "middle_name": "S.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph M Picardi, CNP
• Alana M Picciotti, APN
• Kristi Piller, AGACNP-BC
• Mariann Pokalo, PHD
• Elizabeth Porter, LPC
• Pranayama Holistic Health
• Premise Health of New Jersey Medical PC
• Premise Health of New Jersey Medical, P.C
• Providence Pediatric Medical Daycare, Inc.
• Q Pharma Inc

• Pediatrics Physician in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.