Martin M Pourkesali, DO

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0S8658 Issued in FL

Practice address

28 Office Park Drive
Palm Coast, FL 32137

Phone

(386) 246-6289

Fax

(386) 246-6389

NPI assigned

May 8, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pourkesali Enterprises LLC

  • Ophthalmology Physician
  • Palm Coast, FL
  • NPI 1326478652
  Medicare reassignment NPD Authorized official
• James P. Powers D.O., P.a.

  • Ophthalmology Physician
  • New Port Richey, FL
  • NPI 1376596551
  Medicare reassignment NPD
• Pourkesali Enterprises LLC

  • Ophthalmology Physician
  • Palm Coast, FL
  • NPI 1972812394
  NPD (past) Authorized official
• The Dietitians Group of West Florida, Inc.

  • Registered Dietitian
  • Palm Harbor, FL
  • NPI 1295161040
  NPD (past)
• Vision One Inc

  • Optometrist
  • Daytona Beach, FL
  • NPI 1457308322
  NPD (past)
• Vision One Inc

  • Optometrist
  • Port Orange, FL
  • NPI 1467538272
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1023067196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 OFFICE PARK DRIVE",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32137",
            "telephone_number": "386-246-6289",
            "fax_number": "386-246-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 OFFICE PARK DRIVE",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32137",
            "telephone_number": "386-246-6289",
            "fax_number": "386-246-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURKESALI",
        "first_name": "MARTIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "0S8658",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "0S8658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Stanley Popielarski, RPT
• Positive Therapy LLC
• Morgan A Potts
• Pourkesali Enterprises LLC
• Pourkesali Enterprises LLC
• Marlene A Powell Ollie, OTR/L
• Brianna Powell
• Leneal Powell, DDS
• Eric Edward Prado, MD
• Aimee Salzer Pragle, PA

• Ophthalmology Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.