Individual provider Active NPI

Brent James Portz, D.O.

  • Internal Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1285016048
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0116028595 Issued in VA
Practice address
1215 Lee St # 800133
Charlottesville, VA 22908-2922
Phone
(434) 924-8661
Fax
(434) 773-6803
NPI assigned
Jun 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0116028595 VA Primary

Addresses

Primary practice location

1215 Lee St # 800133
Charlottesville, VA 22908-2922

Mailing address

1215 Lee Street - Box Number 800133
Charlottesville, VA 22908-0001
Phone (434) 924-8661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20201016001188 NC Practitioner - NephrologyPractitioner - Internal Medicine 7719239300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Nephrology Associates PLLCGroup PAC ID 2264420512, 75 clinicians

Practice addresses (Care Compare)

511 Paladin Dr
Greenville, NC 27834-7826
Phone (252) 752-8880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Nephrology Associates PLLC Nephrology CurrentSince Oct 5, 2020 Accepting new patients

Locations

511 Paladin Dr
Greenville, NC 27834
Phone (252) 317-2280

Interoperability endpoints

  • Direct secure messaging: brent.portz.p55@direct.aac.nextgenshare.com
  • Direct secure messaging: bportz26517@direct.acumenmd.com
  • Direct secure messaging: brent.portz.p214@direct.aac.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1285016048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE STREET - BOX NUMBER 800133",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST # 800133",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229082922",
            "telephone_number": "434-924-8661",
            "fax_number": "434-773-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTZ",
        "first_name": "BRENT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116028595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.