Dodd Randall Portman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8010T Issued in CA

Practice address

1190 Scott Blvd
Santa Clara, CA 95050-4562

Phone

(408) 241-3510

Fax

(408) 247-2605

NPI assigned

Jan 26, 2006

Last updated

Mar 7, 2023By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yura Kim OD IncGroup PAC ID 5193262970, 4 clinicians

Practice addresses (Care Compare)

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.

• Yura Kim OD Inc

  dba Santa Clara Vision Center

  • Corneal and Contact Management Optometrist
  • Santa Clara, CA
  • NPI 1437900321
  Medicare reassignment Care Compare group NPD
• Dodd R Portman, OD, Inc

  • Optometrist
  • Santa Clara, CA
  • NPI 1255544375
  Authorized official Same address or phone
• Steven a. Neunzig, O.D., Inc.

  • Optometrist
  • Santa Clara, CA
  • NPI 1225459795
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1659341097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 SCOTT BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504562",
            "telephone_number": "408-241-3510",
            "fax_number": "408-247-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 SCOTT BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504562",
            "telephone_number": "408-241-3510",
            "fax_number": "408-247-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTMAN",
        "first_name": "DODD",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8010T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "8010T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE #",
            "identifier": "8010T",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BI923Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pooja Goel, DDS and Gurpreet Kaur, RDH, a Professional Dental Corp. (Smiles For Life Dental Group)
• Man Nga Poon
• Martin Porras, PA-C
• Saige Savannah Portera
• Elienaie Abigail Portillo
• Christian Porto, ASW
• Mercedes Posadas Rivas, MD
• Sarah Katherine Poveromo, M.S. P.T.
• Elizabeth Michelle Powers
• Joseph J Poyser, LCPC

• Optometrist in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.