Nicole E Portnoy, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2230 Issued in AZ

Practice address

21001 N Tatum Blvd Ste 20
Phoenix, AZ 85050-4207

Phone

(480) 473-0149

NPI assigned

Oct 8, 2009

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1629303631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3837 E PATRICK LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507328",
            "telephone_number": "303-519-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 20",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504207",
            "telephone_number": "480-473-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTNOY",
        "first_name": "NICOLE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2230",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina N Portillo, M.S., CCC-SLP
• Maria Portillo
• Mario Manuel Portillo, DC
• Jessica Denisse Portillos, DNP-CRNA
• Joseph N. Portnoy, M.D.
• Javier Portocarrero, DMD
• James Cook Portt, PA-C
• Brian E Portugal, O.T.
• Brian David Porvin, DO
• Elizabeth Ann Posek, RD

• Optometrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.