John Michael Porter, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4675 T1450 Issued in OH

Practice address

12794 Royalton Rd
North Royalton, OH 44133-4229

Phone

(440) 237-6964

Fax

(440) 237-4605

NPI assigned

Mar 20, 2006

Last updated

Mar 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elder Care Vision Services Inc

  • Optometrist
  • North Royalton, OH
  • NPI 1407918311
  Medicare reassignment NPD Authorized official
• Premier Eye Care Inc

  • Optometrist
  • North Royalton, OH
  • NPI 1851452825
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1295794279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12794 ROYALTON RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334229",
            "telephone_number": "440-237-6964",
            "fax_number": "440-237-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12794 ROYALTON RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334229",
            "telephone_number": "440-237-6964",
            "fax_number": "440-237-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4675 T1450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0204853",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vladimir Petkovic, DDS
• Philip E. Glanville O.D.,Inc.
• Christine Marie Phillips, PHD
• Danielle Pietruszka
• Nicole Laura Polaski, DPT
• Donald Paul Powers, DDS
• Premier Eye Care Inc
• Jenifer Premura, RN
• Jennifer Rae Prochko
• Rhonda Louise Pugh, LMT

• Optometrist in North Royalton, OH
• Providers in North Royalton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.