Mr Lee W Porter, NP, CNS-PMH is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" physician in Keizer, Oregon. His current practice location is
5305 River Rd N Ste B, Keizer, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 896-1555.
Mr Lee W Porter is licensed to practice in Oregon (license number 202002489CNS-PP) 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 1013932425.
Physician's Profile
| Full Name | Mr Lee W Porter |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 5305 River Rd N Ste B, Keizer, Oregon |
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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: 1013932425
- Provider Enumeration Date: 07/13/2006
- Last Update Date: 12/20/2022
Medicare PECOS Information:
- PECOS PAC ID: 3072541580
- Enrollment ID: I20160510002557
Medical Identifiers
Medical identifiers for Mr Lee W Porter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013932425 | NPI | - | NPPES |
| 3072541580 | Other | OR | PECOS PAC ID |
| I20160510002557 | Other | OR | PECOS PAC ENROLLMENT ID |
| 131VX | Other | NC | BLUE CROSS PROVIDER ID |
| 500709395 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208VP0000X | Pain Medicine - Pain Medicine | 202002489CNS-PP (Oregon) | Secondary |
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 163552 (North Carolina) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | 201501835NP-PP (Oregon) | Secondary |
| 364SP0808X | Clinical Nurse Specialist - Psychiatric/mental Health | 201501835NP-PP (Oregon) | Secondary |
| 364SP0809X | Clinical Nurse Specialist - Psychiatric/mental Health, Adult | 202002489CNS-PP (Oregon) | Secondary |
| 364SP0811X | Clinical Nurse Specialist - Psychiatric/mental Health, Chronically Ill | 201501835NP-PP (Oregon) | Secondary |
| 364SP0813X | Clinical Nurse Specialist - Psychiatric/mental Health, Geropsychiatric | 202002489CNS-PP (Oregon) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 202002489CNS-PP (Oregon) | 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. Mr Lee W Porter 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 |
|---|
Mr Lee W Porter, NP, CNS-PMH
65 Division Ave Unit 299,
Eugene, OR 97404-2485
Ph: (541) 896-1555 | Mr Lee W Porter, NP, CNS-PMH
5305 River Rd N Ste B,
Keizer, OR 97303-5324
Ph: (541) 896-1555 |
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