Individual provider Active NPI

Michele Ann Potempa, MD

  • Family Medicine Physician
  • Lockport, NY
National Provider Identifier
1023072055
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
204948 Issued in NY
Practice address
5879 Snyder Dr
Lockport, NY 14094-9497
Phone
(716) 433-8751
Fax
(716) 433-8792
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 204948 NY Primary

Addresses

Primary practice location

5879 Snyder Dr
Lockport, NY 14094-9497

Mailing address

5879 Snyder Dr
Lockport, NY 14094-9497
Phone (716) 433-8751

Other identifiers 5

IdentifierTypeStateIssuer
000525243002OtherNYBCBS OF WNY
0110085OtherNYINDEPENDENT HEALTH
00010365201OtherNYUNIVERA
040426003629OtherNYFIDELIS
01832113MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051017000785 NY Practitioner - Family Practice 7214910629 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204948NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Wny PC CurrentSince Mar 19, 2017 Accepting new patients
Trinity Medical Wny PC CurrentSince Mar 19, 2017 Accepting new patients
Highgate Medical Group Family Medicine PastSince Oct 29, 2023 Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

5879 Snyder Dr
Lockport, NY 14094
Phone (716) 206-1503

Interoperability endpoints

  • Direct secure messaging: mpotempa@gppc.medentdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023072055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5879 SNYDER DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949497",
            "telephone_number": "716-433-8751",
            "fax_number": "716-433-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5879 SNYDER DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949497",
            "telephone_number": "716-433-8751",
            "fax_number": "716-433-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTEMPA",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "204948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WNY",
            "identifier": "000525243002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0110085",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010365201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426003629",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01832113",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.