THEODORE B PORTER D.O.
NPI 1689672479
Family Medicine in Philadelphia, PA

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since July 14, 2005PECOS Enrolled

1413 W MOYAMENSING AVE, 1ST FLOOR, PHILADELPHIA, PA 19145(267) 639-2555(267) 639-2632 Get Directions Write a Review

NPPES record last updated: March 12, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Theodore B Porter D.o. NPPES

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

THEODORE B PORTER D.O. (NPI 1689672479) is an individual family medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (OS003735L) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689672479

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameTHEODORE B PORTERCredential: D.O.

Location Address1413 W MOYAMENSING AVE, 1ST FLOORPhiladelphia, PA 19145-4625

Mailing Address1413 W Moyamensing Ave, 1st FloorPhiladelphia, PA 19145-4625 · (267) 639-2555 · Fax (267) 639-2632

Phone(267) 639-2555

Fax(267) 639-2632

Sole ProprietorYes

Enumeration DateJuly 14, 2005

Last NPPES UpdateMarch 12, 2013

✔ NPI 1689672479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in PA · OS003735L

Definition

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.

1413 W MOYAMENSING AVE, Philadelphia, PA 19145

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theodore B Porter D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19145 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.