National Provider Identifier Database

RUSSELL PORTER, MD – NPI #1275511560
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.


Contact Information

RUSSELL PORTER, MD
2000 NORTH VILLIAGE AVE
STE 307
ROCKVILLE CENTRE, NY11570-1001
Phone: 516-766-5051
Fax: 516-766-2476
Website:
Specialty Taxonomy Code
* Family Medicine 207Q00000X
Geriatric Medicine 207RG0300X
Sports Medicine 207XX0005X

* Indicates primary specialty

NPI Profile & details for RUSSELL PORTER

NPI Number 1275511560
Credentials MD
Entity Individual
Enumeration date 01/06/2006
Last updated 03/07/2023 - About 3 years ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 136530
  • NY Medicaid: 00598458
  • Other: 36A761 BCBS
  • Other: AB45677 MDNY
  • Other: AP970 OXFORD
  • Other: OC7613 PHS
  • Other: 927080 PHS FOR REFERRALS
  • Other: 2590505 UNEMPLOYMENT ER
  • Other: 559637 US HEALTHCARE
  • NY Other: CFP1365303 WC
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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