Active NPI
Nicolas Fuentes Portugueiz, M.D
- Surgery Physician
- Cleveland, OH
National Provider Identifier
1093339384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35.155337
- Practice address
- 9500 Euclid Ave # JJ24
Cleveland, OH 44195-0001 - Phone
- (216) 440-2200
- NPI assigned
- Jun 2, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35.155337 | OH | Primary |
Addresses
Primary practice location
9500 Euclid Ave # JJ24
Cleveland, OH 44195-0001
Mailing address
9500 Euclid Ave # JJ24
Cleveland, OH 44195-0001
Phone (216) 440-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.155337 | OH | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786147200000",
"number": "1093339384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE # JJ24",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "216-440-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE # JJ24",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "216-440-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES PORTUGUEIZ",
"first_name": "NICOLAS",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-02",
"last_updated": "2026-08-08",
"certification_date": "2026-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "OH",
"license": "35.155337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.