Organization Active NPI

Joseph a Potocki DO Inc

  • Family Medicine Physician
  • Niles, OH
National Provider Identifier
1023406931
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOSEPH A POTOCKI DO INC
Practice address
531 Robbins Ave
Niles, OH 44446-2411
Phone
(330) 544-3431
Fax
(330) 544-3432
NPI assigned
Dec 30, 2014
Last updated
Feb 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Dr. Joseph A Potocki, D.O.NPI 1326017880
Title
Owner
Phone
(330) 544-3431

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

531 Robbins Ave
Niles, OH 44446-2411

Mailing address

531 Robbins Ave
Niles, OH 44446-2411
Phone (330) 544-3431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150113001821 OH Part B Supplier - Clinic/Group Practice 3870817208 Receives reassigned benefits from 1 practitioner
Practice locations: Niles, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0341386Joseph a Potocki DO Inc531 Robbins Avenue, Niles, OH 44446Certificate of waiverSep 5, 2026

National Provider Directory

National Provider Directory

Locations

531 Robbins Ave
Niles, OH 44446
Phone (330) 544-3431

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1023406931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 ROBBINS AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462411",
            "telephone_number": "330-544-3431",
            "fax_number": "330-544-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 ROBBINS AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462411",
            "telephone_number": "330-544-3431",
            "fax_number": "330-544-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH A POTOCKI DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "POTOCKI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-544-3431",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.