Pourkesali Enterprises LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

OS8658 Issued in FL

Legal business name

POURKESALI ENTERPRISES LLC

Practice address

391 Palm Coast Pkwy SW Unit 2
Palm Coast, FL 32137-4766

Phone

(386) 246-6289

Fax

(386) 246-6389

NPI assigned

Nov 22, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Martin M Pourkesali, D.ONPI 1023067196

Title

President

Phone

(386) 246-6289

Specialties & licenses 1

Addresses

Other names 1

• Palm Coast Eye Physicians Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Palm Coast Eye Physicians2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pourkesali Enterprises LLC

  • Ophthalmology Physician
  • Palm Coast, FL
  • NPI 1972812394
  NPD tax ID

Locations

Practitioners 1

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

• Martin M Pourkesali, DO

  • Ophthalmology Physician
  • Palm Coast, FL
  • NPI 1023067196
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1326478652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 PALM COAST PKWY SW UNIT 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374766",
            "telephone_number": "386-246-6289",
            "fax_number": "386-246-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 PALM COAST PKWY SW UNIT 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374766",
            "telephone_number": "386-246-6289",
            "fax_number": "386-246-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POURKESALI ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "POURKESALI",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-246-6289",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS8658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Coast Eye Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barry Steven Poliner, M.D.
• Kristin Addona Pontes, D.P.T.
• Bruce Stanley Popielarski, RPT
• Positive Therapy LLC
• Morgan A Potts
• Pourkesali Enterprises LLC
• Martin M Pourkesali, DO
• Marlene A Powell Ollie, OTR/L
• Brianna Powell
• Leneal Powell, DDS

• Ophthalmology Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.