Individual provider Active NPI

Vishnu Choudhary Potini, MD

  • Orthopaedic Surgery Physician
  • Newark, NJ
National Provider Identifier
1013207208
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
078464 Issued in GA
Practice address
90 Bergen St
Doc Suite 7300
Newark, NJ 07103-2425
Phone
(973) 972-2150
NPI assigned
Apr 9, 2011
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2749-320 WI
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 078464 GA Primary

Addresses

Primary practice location

90 Bergen St
Doc Suite 7300
Newark, NJ 07103-2425

Mailing address

2300 Manchester Expy
Ste 101a
Columbus, GA 31904-6802
Phone (706) 320-3128

Other practice location 1

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 929-2300

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vpotini444472@direct-ehr-ssmhc.com Direct AGNESIAN HEALTHCARE INC
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other AGNESIAN HEALTHCARE INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA, WI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20171211002425 GA Practitioner - Orthopedic Surgery 9032409644 Reassigns benefits to 1 organization
I20211111001959 PA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 9032409644 Reassigns benefits to 1 organization
I20230315001185 WI Practitioner - Orthopedic Surgery 9032409644 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Nov 24, 2021 Accepting new patients
St. Francis Physician Practices LLC Current Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Feb 20, 2023 Accepting new patients
St. Francis Physician Practices LLC CurrentSince Oct 1, 2017 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Agnesian Healthcare Inc Orthopaedic Surgery CurrentSince Feb 20, 2023 Accepting new patients
St Francis Physician Practices LLC CurrentSince Oct 1, 2017 Accepting new patients

Locations

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2300 Manchester Expy
Ste A101A
Columbus, GA 31904
Phone (706) 320-3128

18 Deatrick Dr
Gettysburg, PA 17325
Phone (717) 339-2500

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

421 Camelot Dr
Fond du Lac, WI 54935
Phone (920) 923-7940

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

Interoperability endpoints

  • Direct secure messaging: vpotini291319@wellspan.direct-ci.com
  • Direct secure messaging: vpotini444472@direct-ehr-ssmhc.com
  • Direct secure messaging: vpotini445801@direct.hfhs.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1302307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1013207208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY",
            "address_2": "STE 101A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-320-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "address_2": "DOC SUITE 7300",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-929-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTINI",
        "first_name": "VISHNU",
        "middle_name": "CHOUDHARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-09",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "2749-320",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "078464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vpotini444472@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "vpotini444472@direct-ehr-ssmhc.com",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.