NPIMap

Organization Active NPI

Portland Orthopaedic Associates LLC

  • Orthopaedic Surgery Physician
  • Rochester, NY
National Provider Identifier
1629185756
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1436371 Issued in NY
Legal business name
PORTLAND ORTHOPAEDIC ASSOCIATES LLC
Practice address
1299 Portland Avenue
Suite 16
Rochester, NY 14621
Phone
(585) 266-3300
Fax
(585) 266-2163
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael A Niles, MD
Title
Solo Practitioner
Phone
(585) 266-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 1436371 NY Primary

Addresses

Primary practice location

1299 Portland Avenue
Suite 16
Rochester, NY 14621

Mailing address

1299 Portland Avenue
Suite 16
Rochester, NY 14621
Phone (585) 266-3300

Other identifiers 3

IdentifierTypeStateIssuer
01430097MedicaidNY
0181311590OtherNYEXCELLOS
102371CUOtherNYPREFERRED CARE

National Provider Directory

National Provider Directory

Locations

1299 Portland Ave
Ste 16
Rochester, NY 14621
Phone (585) 266-3300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629185756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 PORTLAND AVENUE",
            "address_2": "SUITE 16",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-266-3300",
            "fax_number": "585-266-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 PORTLAND AVENUE",
            "address_2": "SUITE 16",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-266-3300",
            "fax_number": "585-266-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND ORTHOPAEDIC ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NILES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLO PRACTITIONER",
        "authorized_official_telephone_number": "585-266-3300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "1436371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01430097",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLOS",
            "identifier": "0181311590",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "102371CU",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.