NPIMap

Individual provider Active NPI

Michael E Porvaznik, MD

  • Family Medicine Physician
  • Bloomington, IN
National Provider Identifier
1689679482
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01060166A Issued in IN
Practice address
3211 W Reddy Way
Bloomington, IN 47403-4066
Phone
(812) 825-0777
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01060166A IN Primary

Addresses

Primary practice location

3211 W Reddy Way
Bloomington, IN 47403-4066

Mailing address

3211 W Reddy Way
Bloomington, IN 47403-4066
Phone (812) 825-0777

Other identifiers 1

IdentifierTypeStateIssuer
200510710MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050228000678 IN Practitioner - Family Practice 8426001686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monroe Medical Group IncGroup PAC ID 0446576680, 25 clinicians

Practice addresses (Care Compare)

3209 W Reddy Way
Suite C
Bloomington, IN 47403-4089
Phone (812) 825-6006

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Bloomington, IN, CCN 157578
  • Elara Caring Home health agency, Kokomo, IN, CCN 157586
  • Select Home Health Services, Inc Home health agency, Carmel, IN, CCN 157635
  • Indiana Masonic Home, Inc Home health agency, Franklin, IN, CCN 157700
  • Monroe Hospital Hospital, Bloomington, IN, CCN 150183
  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328

Merit-based Incentive Payment System (MIPS)

Final score
80.71 of 100Reported as group
Quality
56.86
Promoting interoperability
97
Improvement activities
40
Cost
81.33

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Medical Group Inc Family Medicine CurrentSince Jan 1, 2017 Accepting new patients
Major Hospital Past Accepting new patients
Mercy Hospital South Past Accepting new patients
Ima Inc Laboratory Past Accepting new patients

Locations

3209 W Reddy Way
Ste C
Bloomington, IN 47403
Phone (812) 825-6006

3211 W Reddy Way
Bloomington, IN 47403
Phone (812) 825-0777

421 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-4468

Interoperability endpoints

  • Direct secure messaging: michael.porvaznik.1@8479.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8479/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1689679482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 W REDDY WAY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034066",
            "telephone_number": "812-825-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 W REDDY WAY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034066",
            "telephone_number": "812-825-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORVAZNIK",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01060166A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200510710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.