MODERN PEDIATRICS PROFESSIONALS, PLLC
NPI 1154952505
Pediatrics in Austin, TX

Q: What is Modern Pediatrics Professionals, PLLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since February 03, 2020CLIA 45D2180634 · Waiver

2309 SANTA MARIA ST, AUSTIN, TX 78702(319) 541-7604 Get Directions Write a Review

NPPES record last updated: February 3, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Modern Pediatrics Professionals, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MODERN PEDIATRICS PROFESSIONALS, PLLC (NPI 1154952505) is a healthcare organization registered as a pediatrics in Austin, Texas and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through March 17, 2028 and lists Timothy James Porter, Chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1154952505

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameMODERN PEDIATRICS PROFESSIONALS, PLLC

Location Address2309 SANTA MARIA STAustin, TX 78702-4617

Mailing Address2309 Santa Maria StAustin, TX 78702-4617 · (319) 541-7604

Phone(319) 541-7604

Organization SubpartNo

Authorized OfficialTimothy James PorterChief Medical Officer · (319) 541-7604

Enumeration DateFebruary 3, 2020

✔ NPI 1154952505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2309 SANTA MARIA ST, Austin, TX 78702

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2180634

Modern Pediatrics Professionals, PLLC · Austin, TX

Active · expires Mar 17, 2028

CLIA Number45D2180634

Laboratory TypeHouse-Calls Only

Certificate Effective DateMarch 18, 2026

Certificate Expiration DateMarch 17, 2028

Laboratory DirectorTimothy J. Porter

Laboratory Phone(319) 541-7604

Laboratory LocationModern Pediatrics Professionals, PLLC2106 Rabb Glen Street, Austin, TX 78704

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELSEY HYDE DNP, FNP-C

Pediatrics