Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Therese Porta, PA-C

Individual provider Physician Assistant · NPI 1174783005

Mary Therese Porta, PA-C is a Physician Assistant in Troy, Michigan. Qualified in 2008, 18 years ago. Practices with Beaumont Medical Group Hospital Based Services, a 572-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
18
Licensed in
MI
In the registry since
2008
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

44201 Dequindre Rd Ste EC
Troy, MI 48085-1117
Phone: (248) 964-5111
Fax: (248) 964-5068
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601005244 (MI)

Record details

NPI number1174783005
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 13, 2008
Last updated in NPPESJuly 28, 2022
Certification dateJuly 28, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Beaumont Medical Group Hospital Based Services — 572 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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