Individual provider Active NPI

Michael Porubcin, MD

  • Hematology & Oncology Physician
  • Moline, IL
National Provider Identifier
1770553349
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036100264 Issued in IL
Practice address
600 John Deere Road
Suite 200
Moline, IL 61265-6897
Phone
(309) 779-4200
Fax
(309) 779-4305
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036100264 IL Primary

Addresses

Primary practice location

600 John Deere Road
Suite 200
Moline, IL 61265-6897

Mailing address

600 John Deere Road
Suite 200
Moline, IL 61265-6897
Phone (309) 779-4200

Other identifiers 2

IdentifierTypeStateIssuer
130020688OtherILRR MEDICARE
036100264MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Michael.porubcin@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061106000409 IL Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Infectious DiseasePractitioner - Hematology/Oncology 3779488788 Reassigns benefits to 1 organization
I20190104000819 IA Practitioner - Hematology/OncologyPractitioner - Medical Oncology 3779488788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 6103829338, shared by 2 NPIs, 262 clinicians

Practice addresses (Care Compare)

1351 W Central Park Ave
Mercyone Genesis
Davenport, IA 52804-1853
Phone (563) 421-1900

801 Illini Dr
Silvis, IL 61282-1804
Phone (309) 281-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.51 of 100Reported as individual
Quality
47.26
Promoting interoperability
97
Improvement activities
40
Cost
75.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036100264ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Specialty Clinic CurrentSince Mar 21, 2022 Accepting new patients
Medical Associates of Clinton, Iowa P.L.C. Hematology & Oncology Current Accepting new patients
Mercy Specialty Clinic CurrentSince Mar 21, 2022 Accepting new patients
Genesis Health System Hematology & Oncology CurrentSince Oct 1, 2019 Accepting new patients
Genesis Health System CurrentSince Oct 1, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Genesis Health System Past Accepting new patients

Locations

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

915 13th Ave N
Clinton, IA 52732
Phone (319) 243-2511

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

1351 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-1900

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

621 S Illinois Ave
Ste 103
Mason City, IA 50401

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000

Interoperability endpoints

  • Direct secure messaging: michael.porubcin@direct.genesishealth.com

Organizations & group practices 7

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 6

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1770553349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE ROAD",
            "address_2": "SUITE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656897",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE ROAD",
            "address_2": "SUITE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656897",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORUBCIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036100264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "130020688",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100264",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michael.porubcin@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1351 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.