Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1174783005 Individual Practitioner Female Practitioner

Mary Therese Porta , PA-C

Physician Assistant • Troy, MI

Professional Overview & Biography Verified Profile Summary

Mary Porta, PA-C is a registered healthcare professional specializing in Physician Assistant in Troy, MI. Practice services are available at 44201 DEQUINDRE RD under active NPI credentials.

Frequently performed procedures and clinical services include critical care, first, emergency department visit for life threatening or functioning severity, emergency department visit with moderate level of medical decision making. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

44201 Dequindre Rd
Suite Ec

Troy, MI 480851117

Telephone 2489645111
Fax 2489645068
Associated Practice Facility / Clinic
🏢 William Beaumont Hospital Facility NPI 1306825997

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Troy, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
239 Specialists

Practicing in Troy, MI (7057 Statewide)

Telehealth Adoption Rate
8.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
69.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99291 Critical care, first 30-74 minutes
34 33 $725.00 $184.77
99285 Emergency department visit for life threatening or functioning severity
20 20 $400.00 $153.95

Medical Specialties & State Licenses

CMS Verified: 2022-07-28
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MI 5601005244

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bcbsm
110F376980 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Courtney Crowley , CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1023781705

CPNPPC

NPI 1033192059

Doctor of Medicine (M.D.)

Danielle Braniecki , PA-C

Physician Assistant

NPI 1033444369

Physician Assistant (Certified)

Jennifer Walster

Physician Assistant

NPI 1043538630
Tamara Loy

Nurse Practitioner - Pediatrics

NPI 1053739706
Brittany Shamoun

Nurse Practitioner

NPI 1053848614

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Business Mailing Address July 28, 2022

Registered at 26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 480333849 (Tel: 9475221865)

NPI Profile Active March 10, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 10, 2017

Registered at 44201 DEQUINDRE RD, SUITE EC, TROY, MI 480851117 (Tel: 2489645111)

📍
Updated Business Mailing Address March 10, 2017

Registered at 130 TOWN CENTER DR, SUITE 203, TROY, MI 480841744 (Tel: 2485858265)

👤
Provider Name / Credentials Updated March 10, 2017

Recorded as MARY PORTA, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 10, 2017

Physician Assistant (License #5601005244 in MI)

NPI Profile Active June 13, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location June 13, 2008

Registered at 3601 W 13 MILE RD, ROYAL OAK, MI 480736712 (Tel: 2484232454)

📍
Updated Business Mailing Address June 13, 2008

Registered at 3601 W 13 MILE RD, ROYAL OAK, MI 480736712 (Tel: 2484232454)

👤
Provider Name / Credentials Updated June 13, 2008

Recorded as MARY GREEN, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 13, 2008

Physician Assistant (License #5601005244 in MI)

🟢
Initial NPI Registration & Enumeration June 13, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Mary Porta. Be the first to share your experience!

Sign in to leave a review for Mary Porta

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1174783005
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 13, 2008
Last Update: July 28, 2022
Sole Proprietor: No

Mailing Address

26901 Beaumont Blvd Ste 3d

Southfield, MI 480333849

Phone: 9475221865

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.