Provider Demographics
NPI:1144221102
Name:PORTNOY, SCOTT LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LAWRENCE
Last Name:PORTNOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2026 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1902
Mailing Address - Country:US
Mailing Address - Phone:412-381-1542
Mailing Address - Fax:412-381-6662
Practice Address - Street 1:2853 FREEPORT ROAD
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065
Practice Address - Country:US
Practice Address - Phone:724-224-4240
Practice Address - Fax:724-224-3197
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043503E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
100723OtherUPMC HEALTH PLAN
4550PAOtherVISION BENEFITS OF AMERIC
81633OtherHEALTH AMERICA/HEALTH ASS
MD043503EOtherCIGNA
PA0011990950009Medicaid
600838OtherBLUE CROSS
MD043503EOtherTRICARE FOR LIFE
0279190001OtherUNITED HEALTHCARE DMERC
0011990950009OtherMED PLUS/THREE RIVERS
80155OtherAETNA
180037688OtherUNITED HEALTHCARE
0017322OtherDORAL VISION SERVICES
1039208OtherGATEWAY HEALTH PLAN
4550PAOtherVISION SERVICE PLAN
MD043503EOtherCIGNA
E41001Medicare UPIN
PA0011990950009Medicaid