NPIMap

Individual provider Active NPI

Irina Merport, M.D.

  • Internal Medicine Physician
  • Fall River, MA
National Provider Identifier
1992760912
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
158516 Issued in MA
Practice address
1030 President Ave
Suite 1001
Fall River, MA 02720-5923
Phone
(508) 973-9650
Fax
(508) 973-9655
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 158516 MA Primary

Addresses

Primary practice location

1030 President Ave
Suite 1001
Fall River, MA 02720-5923

Mailing address

200 Mill Rd
Ste 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Other identifiers 2

IdentifierTypeStateIssuer
IM35917MedicaidRI
110003186AMedicaidMA

Other names 1

  • Stephanie Vrontisis Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address imerport6109@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061220000010 MA Practitioner - Internal Medicine 4183623184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

1030 President Ave
Suite 1001
Fall River, MA 02720-5923
Phone (508) 973-9650

Hospital & facility affiliations

  • Southcoast Visiting Nurse Association Inc Home health agency, Fairhaven, MA, CCN 227101
  • Nightingale Visiting Nurses Home health agency, Taunton, MA, CCN 227215
  • Community Nurse Home Care Home health agency, Fairhaven, MA, CCN 227027
  • Centerwell Home Health Home health agency, Fall River, MA, CCN 227260
  • Bayada Home Health Care, Inc Home health agency, Falmouth, MA, CCN 227539
  • Hospice and Palliative Care Hospice, Fairhaven, MA, CCN 221536
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
  • Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020
  • Fall River Jewish Home Nursing home, Fall River, MA, CCN 225317

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Hospitals Group, Inc CurrentSince Jun 26, 2000 Accepting new patients
Southcoast Physicians Group, Inc. Internal Medicine CurrentSince Jul 14, 2000 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jul 14, 2000 Accepting new patients
Southcoast Hospitals Group Inc CurrentSince Jun 26, 2000 Accepting new patients
Southcoast Physician Services Inc Internal Medicine Past Accepting new patients
Oc Jewish Home Center LLC Past Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

1030 President Ave
#1001
Fall River, MA 02720

1030 President Ave
#306C
Fall River, MA 02720
Phone (508) 676-3411

1030 President Ave
Ste 1001
Fall River, MA 02720
Phone (508) 973-9650

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

1030 President Ave
Fall River, MA 02720
Phone (508) 235-6427

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

Interoperability endpoints

  • Direct secure messaging: imerport6109@direct.southcoast.org

Organizations & group practices 6

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1992760912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 PRESIDENT AVE",
            "address_2": "SUITE 1001",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205923",
            "telephone_number": "508-973-9650",
            "fax_number": "508-973-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERPORT",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "158516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IM35917",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110003186A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imerport6109@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "1030 President Ave",
            "address_2": "Suite 1001",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027205923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "VRONTISIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.