NPIMap

Individual provider Active NPI

David J. Portonova, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Bloomsburg, PA
National Provider Identifier
1457606865
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006404 Issued in PA
Practice address
6850 Lows Rd Ste 316
Bloomsburg, PA 17815-8708
Phone
(570) 387-2202
Fax
(570) 387-2203
NPI assigned
Jul 23, 2012
Last updated
Sep 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006404 PA Primary

Addresses

Primary practice location

6850 Lows Rd Ste 316
Bloomsburg, PA 17815-8708

Mailing address

PO Box 1935
Kingston, PA 18704-0935
Phone (570) 288-8881

Other practice location 1

642 Brookhill Square
Route 93 Ste 36-1
Conyngham, PA 18219-0860
Phone (570) 359-2024

Other practice location 2

87 Oxford St
Hanover Twp, PA 18706-3350
Phone (570) 829-3668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150622001749 PA Practitioner - Podiatry 1951612613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Hahnemann University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Portonova Foot and Ankle Specialists LLCGroup PAC ID 1456669746, 2 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

6850 Lows Rd
Suite 316
Bloomsburg, PA 17815-8708
Phone (570) 387-2202

87 Oxford St
Hanover Township, PA 18706-3350
Phone (570) 829-3668

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue353
Removal of skin lesions1-10
Removal of nail tissue1269
Removal or shaving of skin growth1102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Care Urgent and Family Care CurrentSince Nov 22, 2020 Accepting new patients
Portonova Foot and Ankle Specialists LLC Foot & Ankle Surgery CurrentSince Jun 11, 2015 Accepting new patients
Vascular Diagnostic Center PC Past Accepting new patients
Karen Campbell, DPM PastSince Nov 1, 2020 Accepting new patients

Locations

410 Glen Ave
Ste 201
Bloomsburg, PA 17815
Phone (570) 387-2022

6850 Lows Rd
Ste 316
Bloomsburg, PA 17815
Phone (570) 387-2202

87 Oxford St
Hanover Township, PA 18706
Phone (570) 387-2202

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1457606865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1935",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040935",
            "telephone_number": "570-288-8881",
            "fax_number": "570-288-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 LOWS RD STE 316",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158708",
            "telephone_number": "570-387-2202",
            "fax_number": "570-387-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "642 Brookhill Square",
            "address_2": "Route 93 Ste 36-1",
            "address_purpose": "LOCATION",
            "city": "Conyngham",
            "state": "PA",
            "postal_code": "182190860",
            "country_code": "US",
            "telephone_number": "570-359-2024",
            "fax_number": "570-359-2025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "87 Oxford St",
            "address_purpose": "LOCATION",
            "city": "Hanover Twp",
            "state": "PA",
            "postal_code": "187063350",
            "country_code": "US",
            "telephone_number": "570-829-3668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTONOVA",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2021-09-17",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.