Dr Nicholas Porta, PSYD is a medicare enrolled "Psychologist" provider in Johnson City, Tennessee. His current practice location is
2514 1/2 Wesley St Ste 2, Johnson City, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(423) 529-0385.
Dr Nicholas Porta is licensed to practice in Tennessee (license number P0000003473) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013387687.
Healthcare Provider's Profile
| Full Name | Dr Nicholas Porta |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 2514 1/2 Wesley St Ste 2, Johnson City, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1013387687
- Provider Enumeration Date: 09/25/2015
- Last Update Date: 03/21/2018
Medicare PECOS Information:
- PECOS PAC ID: 0941588636
- Enrollment ID: I20180607001958
Medical Identifiers
Medical identifiers for Dr Nicholas Porta such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013387687 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 2015033025 (Missouri) | Secondary |
| 103T00000X | Psychologist | P0000003473 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nicholas Porta is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Nicholas Porta, PSYD
2514 1/2 Wesley St Ste 2,
Johnson City, TN 37601-1754
Ph: (423) 529-0385 | Dr Nicholas Porta, PSYD
2514 1/2 Wesley St Ste 2,
Johnson City, TN 37601-1754
Ph: (423) 529-0385 |
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