PORTER PHYSICIAN SERVICES LLC
NPI 1457566309
Internal Medicine in Portage, IN
NPI Status: Active since May 14, 2007
Contact Information
3630 WILLOWCREEK RD
PORTAGE, IN
ZIP 46368
Phone: (219) 759-5791
Fax: (219) 759-3807
- Organization
- Internal Medicine
- Accepts Insurance
- CLIA Number: 15D0925904
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-22-2026
About PORTER PHYSICIAN SERVICES LLC
This page provides the complete NPI Profile along with additional information for Porter Physician Services Llc, an internist established in Portage, Indiana operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1457566309 assigned on May 2007. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. Porter Physician Services Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Debbie T Brewer (Director Of Provider Enrollment)
- NPI
- 1457566309
- Provider Name
- PORTER PHYSICIAN SERVICES LLC
- Entity Type
- Organization
- Location Address
- 3630 WILLOWCREEK RD PORTAGE, IN 46368
- Location Phone
- (219) 759-5791
- Location Fax
- (219) 759-3807
- Mailing Address
- 3630 WILLOWCREEK RD PORTAGE, IN 46368
- Mailing Phone
- (219) 759-5791
- Mailing Fax
- (219) 759-3807
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-14-2007
- Last Update Date
- 01-28-2009
- Code Navigator
An internist like Porter Physician Services Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - PPO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 252000 | MEDICARE PIN (08) | IN | |
| 200866880A | MEDICAID (05) | IN | |
| 5437180002 | MEDICARE PIN (08) | IN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D0925904
- Facility Type
- Physician Office
- Certificate Effective Date
- July 23, 2024
- Certificate Expiration Date
- July 22, 2026
- Laboratory Director
- DR. KAJAL PURANIK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Porter Physician Services Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PORTER PHYSICIAN SERVICES LLC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 5 | 7 | 5 | 6 | 6 | 3 | 0 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 10 | 7 | 10 | 6 | 12 | 3 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 0 + 7 + 1 + 0 + 6 + 1 + 2 + 3 + 0 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1457566309 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1649213554 | MICHAEL M BERMUDEZ MD Individual | Emergency Medicine | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3000 |
| 1245312586 | ASSOCIATES IN SURGERY, PC Organization | Surgery | 3630 WILLOWCREEK RD SUITE 3 PORTAGE, IN 46368 (219) 759-4577 |
| 1467510677 | BAQHAR MOHIDEEN MD, PC Organization | Internal Medicine (Pulmonary Disease) | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-1441 |
| 1780742353 | BAQHAR MOHIDEEN MD Individual | Internal Medicine (Pulmonary Disease) | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-1441 |
| 1689841165 | WOMEN'S MEDICAL CARE LLC Organization | Obstetrics & Gynecology | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-1389 |
| 1063668614 | KOTA MEDICAL PC Organization | Internal Medicine (Gastroenterology) | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-5812 |
| 1124452628 | RANGA KOTA MD, PC Organization | Internal Medicine (Gastroenterology) | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-5812 |
| 1033507538 | ATLANTIC SILVERSIDE EMERGENCY PHYSICIANS LLC Organization | Emergency Medicine | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (469) 401-2386 |
| 1316258874 | DR. SHANE DAVID BUSH M.D. Individual | Family Medicine | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3700 |
| 1336519685 | HEATHER BOLAN Individual | Speech-Language Pathologist | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3000 |
| 1346616646 | PORTER GROUP SERVICES, LLC Organization | Hospitalist | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3000 |
| 1821059148 | DONALD SQUIRES DUNEVANT MD Individual | Family Medicine | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-5791 |
| 1396383881 | JED LEIFSON Individual | Nurse Anesthetist, Certified Registered | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3000 |
| 1558322982 | PORTER HEALTH SERVICES Organization | Internal Medicine | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-5791 |
| 1952469538 | ASSOCIATED PEDIATRICIANS, LLC Organization | Specialist | 3630 WILLOWCREEK RD SUITE 6 PORTAGE, IN 46368 (219) 531-7492 |
| 1932145745 | RANGA R KOTA M.D. Individual | Internal Medicine (Gastroenterology) | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 759-5812 |
| 1891135620 | DR. KAJAL PATEL PURANIK M.D. Individual | Family Medicine | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3700 |
| 1366961757 | MS. CRISTINA LUBASH FNP Individual | Nurse Practitioner (Family) | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3700 |
| 1508411315 | CHAD ANTHONY BOGUE NP Individual | Nurse Practitioner (Family) | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3700 |
| 1780645093 | DR. CANDICE MICHELLE YU-FLEMING MD Individual | Family Medicine | 3630 WILLOWCREEK RD PORTAGE, IN 46368 (219) 364-3700 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457566309, enumerated in the NPI registry as an "organization" on May 14, 2007
The provider is located at 3630 Willowcreek Rd Portage, In 46368 and the phone number is (219) 759-5791
This medical organization specializes in Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Aetna CVS Health, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 15D0925904 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on May 14, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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