Organization Active NPI

Dodd R Portman, OD, Inc

  • Optometrist
  • Santa Clara, CA
National Provider Identifier
1255544375
Registry record updated Feb 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8010 TPL Issued in CA
Legal business name
DODD R PORTMAN, OD, INC
Practice address
1190 Scott Blvd
Santa Clara, CA 95050-4562
Phone
(408) 241-3510
Fax
(408) 247-2605
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2009

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

Authorized official

Name
Dr. Dodd Randall Portman, O.D.
Title
President
Phone
(408) 241-3510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 8010 TPL CA Primary

Addresses

Primary practice location

1190 Scott Blvd
Santa Clara, CA 95050-4562

Mailing address

1190 Scott Blvd
Santa Clara, CA 95050-4562
Phone (408) 241-3510

Other identifiers 1

IdentifierTypeStateIssuer
BI921OtherCAMEDICARE PTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235606400000",
    "number": "1255544375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 SCOTT BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504562",
            "telephone_number": "408-241-3510",
            "fax_number": "408-247-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 SCOTT BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504562",
            "telephone_number": "408-241-3510",
            "fax_number": "408-247-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODD R PORTMAN, OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2009-02-26",
        "status": "A",
        "authorized_official_last_name": "PORTMAN",
        "authorized_official_first_name": "DODD",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-241-3510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8010 TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BI921",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.