Tiffany M Potts-Daniel, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010831 Issued in IL

Practice address

303 W Lake St Ste 200
Addison, IL 60101-2500

Phone

(331) 221-1650

Fax

(331) 221-3973

NPI assigned

Sep 14, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1013639392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W LAKE ST STE 200",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012500",
            "telephone_number": "331-221-1650",
            "fax_number": "331-221-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W LAKE ST STE 200",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012500",
            "telephone_number": "331-221-1650",
            "fax_number": "331-221-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS-DANIEL",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Addison, IL
• Providers in Addison, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.