MICHAEL PORT M.D.
NPI 1710005731
Pain Medicine - Pain Medicine in Marina Del Rey, CA
NPI Status: Active since March 27, 2007
Contact Information
13160 MINDANAO WAY
SUITE #300
MARINA DEL REY, CA
ZIP 90292
Phone: (310) 854-3800
Fax: (310) 854-3820
- Individual
- Male
- Pain Medicine
- Pain Medicine
- Opted-Out Medicare
About MICHAEL PORT
This page provides the complete NPI Profile along with additional information for Michael Port, a provider established in Marina Del Rey, California with a medical specialization in Pain Medicine. The healthcare provider is registered in the NPI registry with number 1710005731 assigned on March 2007. The practitioner's primary taxonomy code is 208VP0000X with license number G77719 (CA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1710005731
- Provider Name
- MICHAEL PORT M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 13160 MINDANAO WAY SUITE #300 MARINA DEL REY, CA 90292
- Location Phone
- (310) 854-3800
- Location Fax
- (310) 854-3820
- Mailing Address
- 125 EUCALYPTUS DR EL SEGUNDO, CA 90245
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-27-2007
- Last Update Date
- 09-11-2025
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Michael Port opted out of Medicare effective on 07-01-2020 until 07-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pain Medicine Pain Medicine
- Taxonomy Code
- 208VP0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G77719
- License State
- CA
- Taxonomy Description
- Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | G77719 (CA) |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-01-2020
Opt-Out End Date: 07-01-2026
Eligible to Order and Refer? No
Reviews for MICHAEL PORT M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710005731, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 49 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710005731, enumerated as an "individual" on March 27, 2007.
The provider is located at 13160 MINDANAO WAY SUITE #300 MARINA DEL REY, CA 90292 and the phone number is (310) 854-3800.
Pain Medicine with taxonomy code 208VP0000X.
