JON STEPHEN PORTNOFF (NPI# 1609874445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609874445 |
| Entity Type | Individual |
| Full Name | JON STEPHEN PORTNOFF |
| Credential | M.D. |
| Practice Address |
260 Hospital Dr Suite 207 Ukiah CA 95482-4533 |
| Mailing Address |
Po Box 2739 Ukiah CA 95482-2739 |
| Practice Telephone | 7074632400 |
| Practice Fax Number | 7074633520 |
| Mailing Telephone | 7074638000 |
| Mailing Fax Number | 7074621111 |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2012-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A43219 | CA | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
A43219 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A432190 | 05 | |
| CA | BLUE SHIELD OF CALIFORNIA | 00A432190 | 01 |
| CA | MEDICARE PTAN | ZZZ00872Z | 01 |
| CA | RAILROAD MEDICARE | 060020995 | 01 |
| Street Address |
260 HOSPITAL DR SUITE 207 |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-4533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114557345 | Shakuntala Blomquist | Nurse Practitioner | 260 Hospital Dr, Ukiah, CA 95482-4568 | 2020-01-15 |
| 1184175895 | Adventist Health Physicians Network | Pediatrics | 260 Hospital Dr, Suite 204, Ukiah, CA 95482-4568 | 2016-10-18 |
| 1447701156 | Adventist Health Physicians Network | Family Medicine | 260 Hospital Dr, Suite 209, Ukiah, CA 95482-4568 | 2016-10-18 |
| 1285185991 | Adventist Health Physicians Network | Internal Medicine | 260 Hospital Dr, Suite 103, Ukiah, CA 95482-4568 | 2016-10-18 |
| 1124499413 | Lori Katnik | Nurse Practitioner | 260 Hospital Dr, Ukiah, CA 95482-4568 | 2015-10-13 |
| 1053790915 | Adventist Health Physicians Network | Physical Medicine & Rehabilitation | 260 Hospital Dr, Suite 102, Ukiah, CA 95482-4568 | 2015-05-26 |
| 1659764777 | Adventist Health Physicians Network | Orthopaedic Surgery | 260 Hospital Dr, Suite 107, Ukiah, CA 95482-4568 | 2015-03-13 |
| 1609269984 | Adventist Health Physicians Network | Family Medicine | 260 Hospital Dr, Suite 207, Ukiah, CA 95482-4568 | 2015-03-11 |
| 1326431669 | Adventist Health Physicians Network | Urology | 260 Hospital Dr, Suite 201, Ukiah, CA 95482-4568 | 2015-03-11 |
| 1538566757 | Minerva Stirling | Social Worker | 260 Hospital Dr, Suite 101, Ukiah, CA 95482-4568 | 2014-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902038573 | Ukiah Valley Primary Care Medical Group, Inc | Internal Medicine | 240 Hospital Dr Ste A, Ukiah, CA 95482-4558 | 2009-08-17 |
| 1447258280 | Dale Leroy Morrison | Internal Medicine | 244 Hospital Dr, Ste B, Ukiah, CA 95482-4557 | 2005-07-13 |
| 1467790774 | Adventist Health Physicians Network | Internal Medicine | 115 Hospital Dr, Ukiah, CA 95482-4591 | 2013-01-21 |
| 1447235254 | Benjamin H Meyer | Internal Medicine | 115 Hospital Dr, Ukiah, CA 95482-4591 | 2005-12-14 |
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| 1902465792 | Pacific Heart & Vascular | Internal Medicine | 1234 W. Chapman Ave, Ste #101, Orange, CA 92868-2862 | 2019-06-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.