Individual provider Active NPI

Arvin Pourtorkan, D.O.

  • Family Medicine Physician
  • Guthrie, OK
National Provider Identifier
1396188413
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5614 Issued in OK
Practice address
205 S Academy Rd
Guthrie, OK 73044-8727
Phone
(405) 282-9449
Fax
(405) 282-9403
NPI assigned
Apr 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5614 OK Primary

Addresses

Primary practice location

205 S Academy Rd
Guthrie, OK 73044-8727

Mailing address

205 S Academy Rd
Guthrie, OK 73044-8727
Phone (405) 282-9449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20140804000544 OK Practitioner - Family Practice 6608093307 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5614OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Physicians Group CurrentSince Jun 1, 2017 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

4510 NW 39th St
Oklahoma City, OK 73122
Phone (405) 495-5841

Interoperability endpoints

  • Direct secure messaging: apourtorkan714445@directa.mercy.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1396188413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S ACADEMY RD",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730448727",
            "telephone_number": "405-282-9449",
            "fax_number": "405-282-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S ACADEMY RD",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730448727",
            "telephone_number": "405-282-9449",
            "fax_number": "405-282-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURTORKAN",
        "first_name": "ARVIN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "5614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

Verify at the official NPI Registry.