Mark Rainaldo Porvaznik, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

010690 Issued in AZ

Practice address

1425 S Greenfield Rd Ste 101
Mesa, AZ 85206-5505

Phone

(809) 645-8004

NPI assigned

May 15, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mesa Family Physicians, PLCGroup PAC ID 1456336320, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Mesa Family Physicians, PLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1174723274
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1417513474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065505",
            "telephone_number": "809-645-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065505",
            "telephone_number": "809-645-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORVAZNIK",
        "first_name": "MARK",
        "middle_name": "RAINALDO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-15",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "010690",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Troy Porter, CRNA
• Sydney Porter, PA-S
• Thomas P Porter, M.D.
• Portier Medical Group PLLC
• Kimberly Portugal, LCSW, MPH
• Posada Place LLC
• Diana Posadas, LLC
• Amber Pena Posey, ARNP
• Positively Purple Psychotherapy LLC
• Izabela B Postacchini, MD

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, 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 Dec 3, 2024; 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.