MEDICARE: ROBERT PORTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085D0003X	Diagnostic Neuroimaging (Radiology) Physician	35071752	OH
2	2085N0904X	Nuclear Radiology Physician	35071752	OH
3	2085R0001X	Radiation Oncology Physician	35071752	OH
4	2085R0204X	Vascular & Interventional Radiology Physician	35071752	OH
5	207U00000X	Nuclear Medicine Physician	35071752	OH
6	2085B0100X	Body Imaging Physician	35071752	OH
7	2085H0002X	Hospice and Palliative Medicine (Radiology) Physician	35071752	OH
8	2085R0203X	Therapeutic Radiology Physician	35071752	OH
9	2085R0202X	Diagnostic Radiology Physician	35071752	OH
10	2085N0700X	Neuroradiology Physician	35071752	OH
11	207UN0901X	Nuclear Cardiology Physician	35071752	OH
12	207UN0903X	In Vivo & In Vitro Nuclear Medicine Physician	35071752	OH
13	207UN0902X	Nuclear Imaging & Therapy Physician	35071752	OH
14	2085P0229X	Pediatric Radiology Physician	35071752	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00420608	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000558132	OTHER	OH	ANTHEM
5	4077752	OTHER	OH	AETNA
6	746939	OTHER	OH	BUCKEYE
7	000000234755	OTHER	OH	UNISON
8	0304914	OTHER	OH	BCMH

General Provider Information

NPI Number	:	1194718189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT PORTER MD

Provider Business Mailing Address
First Line	:	24701 EUCLID AVE
Second Line	:	3RD FLOOR
City	:	EUCLID
State	:	OH
Zip	:	44117-1714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 EUCLID AVENUE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106
Country	:	US
Telephone Number	:	216-844-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	12/02/2025

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Directions to “ ROBERT PORTER MD” Practice Location

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