Michael J Portz, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1753 Issued in IA

Practice address

1409 N 2ND St
Red Oak, IA 51566-1043

Phone

(712) 623-5551

Fax

(712) 623-4745

NPI assigned

Aug 9, 2005

Last updated

Jun 13, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael J Portz OD PC

  • Optometrist
  • Red Oak, IA
  • NPI 1225041890
  Medicare reassignment NPD Authorized official
• Michael J. Portz, O.D., P.C.

  • Durable Medical Equipment & Medical Supplies
  • Red Oak, IA
  • NPI 1083748925
  Authorized official Same address or phone

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1568463065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 N 2ND ST",
            "address_2": "PO BOX 463",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515661043",
            "telephone_number": "712-623-5551",
            "fax_number": "712-623-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 N 2ND ST",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515661043",
            "telephone_number": "712-623-5551",
            "fax_number": "712-623-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTZ",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "27984",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078618",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debbie L Pierson
• Edward Piller, MD
• Marcela Ivette Pineda Molina, MD
• Beverly Pippin, PTA
• Planned Parenthood of the Heartland
• Kevin Quinn, MD
• Red Oak Community School District
• Lauren Paige Riley, NP
• Kimberly Ann Roberts, PT
• Adrienne A Rochleau, CRNA

• Optometrist in Red Oak, IA
• Providers in Red Oak, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.