Porvaznik Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PORVAZNIK FAMILY MEDICINE PLLC

Practice address

5200 E Cortland Blvd Ste D3
Flagstaff, AZ 86004-9340

Phone

(928) 440-5929

NPI assigned

Sep 10, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Mary Porvaznik, MDNPI 1871582635

Title

Owner

Phone

(301) 801-2577

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Mary Catherine Porvaznik, MD

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1871582635
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1366278913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 E CORTLAND BLVD STE D3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860049340",
            "telephone_number": "928-440-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 E CORTLAND BLVD STE D3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860049340",
            "telephone_number": "928-440-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORVAZNIK FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "PORVAZNIK",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-801-2577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisling Pomeroy-King, CCC-SLP
• Christopher Pomeroy
• Ponderosa Pines Care and Rehab, Inc
• Mary Carolina Poore, NATUROPATHIC DOCTOR
• Cezar M Popescu, LPC
• Mary Catherine Porvaznik, MD
• Andrew Post, MA
• Kaitlyn E Post, DPT
• Rebecca Poulter, PHARMD
• Jacquelyn Povilaitis, PT, DPT

• Family Medicine Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.