Individual provider Active NPI

Michael R. Ports, M.D.

  • Internal Medicine Physician
  • Westerville, OH
National Provider Identifier
1588648497
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-03-8582 Issued in OH
Practice address
450 Alkyre Run
Suite 380
Westerville, OH 43082-6909
Phone
(614) 899-9188
Fax
(614) 899-9198
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-03-8582 OH Primary

Addresses

Primary practice location

450 Alkyre Run
Suite 380
Westerville, OH 43082-6909

Mailing address

450 Alkyre Run
Suite 380
Westerville, OH 43082-6909
Phone (614) 899-9188

Other identifiers 1

IdentifierTypeStateIssuer
0366205MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080208000355 OH Practitioner - Internal Medicine 1557444916 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. Internal Medicine CurrentSince Dec 1, 2000 Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Dec 1, 2000 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

291 W Schrock Rd
Ste B
Westerville, OH 43081
Phone (614) 776-5750

450 Alkyre Run
Ste 380
Westerville, OH 43082
Phone (614) 839-9173

655 Africa Rd
Westerville, OH 43082

Organizations & group practices 3

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1588648497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 ALKYRE RUN",
            "address_2": "SUITE 380",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430826909",
            "telephone_number": "614-899-9188",
            "fax_number": "614-899-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ALKYRE RUN",
            "address_2": "SUITE 380",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430826909",
            "telephone_number": "614-899-9188",
            "fax_number": "614-899-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTS",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-03-8582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0366205",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.