Michael J Portz OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1753 Issued in IA

Legal business name

MICHAEL J PORTZ OD PC

Practice address

1409 N Second Street
Red Oak, IA 51566-0463

Phone

(712) 623-5551

Fax

(712) 623-4745

NPI assigned

Aug 14, 2006

Last updated

Aug 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael John Portz, ODNPI 1568463065

Title

President

Phone

(712) 623-5551

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael J Portz, OD

  • Optometrist
  • Red Oak, IA
  • NPI 1568463065
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1225041890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 N SECOND STREET PO BOX 463",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515660463",
            "telephone_number": "712-623-5551",
            "fax_number": "712-623-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 N SECOND STREET",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515660463",
            "telephone_number": "712-623-5551",
            "fax_number": "712-623-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J PORTZ OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "PORTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-623-5551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445122",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Patrick McCormack, DDS
• Michael J McGargill, LMHC
• Erin McNamara, M.S., R.D., L.D.
• MD West One, PC
• Samantha Meixell, DPT
• Michael J. Portz, O.D., P.C.
• Mills County (Rolling Prairie Case Mgmt)
• Molly Miner, PHARMD
• Montgomery County
• Montgomery County Memorial Hospital (MCMH Pharmacy)

• Optometrist in Red Oak, IA
• Providers in Red Oak, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.