| Portage Internal Medicine Associates Llc | |
|
503 Overlook Dr Kent OH 44240-5824 | |
| (330) 645-6463 | |
| (330) 645-6462 |
| Full Name | Portage Internal Medicine Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 503 Overlook Dr, Kent, Ohio |
| Authorized Official Name and Position | Dean J Deperro (PHYSICAN) |
| Authorized Official Contact | 3303460800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Portage Internal Medicine Associates Llc Po Box 45519 Westlake OH 44145-0519 Ph: (800) 514-4390 | Portage Internal Medicine Associates Llc 503 Overlook Dr Kent OH 44240-5824 Ph: (330) 645-6463 |
| NPI Number | 1083809784 |
|---|---|
| Provider Enumeration Date | 09/06/2007 |
| Last Update Date | 12/20/2023 |
| Medicare PECOS PAC ID | 1153419189 |
|---|---|
| Medicare Enrollment ID | O20071108000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083809784 | NPI | - | NPPES |
| 2192863 | Medicaid | OH | |
| DO7407 | Other | OH | RAILROAD CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 34006535 (Ohio) | Primary |
| Provider Name | Dean J Deperro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568567410 PECOS PAC ID: 1355399254 Enrollment ID: I20050107000134 |
Occmed Source, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 174 Currie Hall Pkwy, Suite D, Kent, OH 44240 Phone: 330-548-0086 Fax: 330-548-0085 | |
Robinson Health Affiliates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 408 Devon Pl, Kent, OH 44240 Phone: 330-673-6235 | |
Healthspan Integrated Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 State Route 59, Suite 28, Kent, OH 44240 Phone: 216-265-8810 Fax: 216-265-8890 | |
Primary Care Assoc Of N Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 307 W Main St, Suite B, Kent, OH 44240 Phone: 330-678-7782 Fax: 330-678-7301 | |
Age Management & Internal Medicine Consultants Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1949 State Route 59, Suite 102, Kent, OH 44240 Phone: 330-673-0505 Fax: 330-673-8708 | |
Axesspointe Community Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 143 Gougler Ave, Kent, OH 44240 Phone: 330-673-1016 |