MR. JEFFREY SAM PORTER (MD) – Emergency Medicine Physician, NPI 1164496345

MR. JEFFREY SAM PORTER (MD) is a healthcare provider. based in Saint cloud, Minnesota. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 46608 (MN). The NPI Number for MR. JEFFREY SAM PORTER (MD) is 1164496345

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
MR. JEFFREY SAM PORTER (MD)
NPI
1164496345
Phone
(320) 253-1596
Address
1406 6TH AVE N
Enumeration Date
15 February 2006
Last Update Date
29 January 2016

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Secondary Phone
2188287394
Graduation Year
2001 (25 years ago)
PAC ID
3779568266
Group Practice PAC ID
8224948443
Professional Enrollment ID
I20040621000011
Address ID
MN564013054BR523XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,172 EMERGENCY MEDICINE in MN

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Provider Addresses for MR. JEFFREY SAM PORTER (MD)

  • Saint Cloud Hospital, 1406, 6th Avenue North, St. Cloud, Stearns County, Minnesota, 56303, United States

    SAINT CLOUD, MN 563031900

    Phone: (320) 253-1596

    Type: Mailing

  • Essentia Health St Joseph's Medical Center, 523, North 3rd Street, Brainerd, Crow Wing County, Minnesota, 56401, United States

    BRAINERD, MN 564013054

    Phone: (218) 829-2861

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2023-10-04 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-06-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040621000011IEmergency MedicineMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making180166$0
99284Emergency department visit with moderate level of medical decision making102100$0
99283Emergency department visit with low level of medical decision making4544$0
99291Critical care, first 30-74 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 56303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224948443View full group profile
NameSpecialtyState
-MN
Nurse PractitionerMN
Certified Registered Nurse Anesthetist (Crna)ND
Nurse PractitionerMN
Emergency MedicineMN
Nurse PractitionerMN
Certified Registered Nurse Anesthetist (Crna)MN
Diagnostic RadiologyMN
Nurse PractitionerMN
Hospitalist, Internal Medicine, Internal Medicine, HospitalistWI

Reviews

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Frequently asked questions

How do I look up MR. JEFFREY SAM PORTER (MD) by NPI?
Use NPI 1164496345 when you need to reference MR. JEFFREY SAM PORTER (MD) in forms, claims, or directories.
Is MR. JEFFREY SAM PORTER (MD) active in the national directory?
MR. JEFFREY SAM PORTER (MD)'s public NPI profile is in an active state.
What field does MR. JEFFREY SAM PORTER (MD) work in?
You can think of MR. JEFFREY SAM PORTER (MD) as practicing within Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Does MR. JEFFREY SAM PORTER (MD) practice in Minnesota?
You will see Saint Cloud, Minnesota on file for MR. JEFFREY SAM PORTER (MD) alongside any extra practice locations.
What if Saint Cloud, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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