Individual provider Active NPI

John Stepan Pototsky, CRNA

  • Certified Registered Nurse Anesthetist
  • Lexington, KY
National Provider Identifier
1023526522
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3016423 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-1603
Phone
(859) 323-5956
Fax
(859) 323-1080
NPI assigned
Jan 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 119587 NY
Certified Registered Nurse Anesthetist 367500000X 3016423 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-1603

Mailing address

217 Case St
Syracuse, NY 13209-2511

Other practice location 1

725 Irving Ave
Syracuse, NY 13210-1603
Phone (315) 470-8705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180329001975 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183986243
I20211004002119 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183986243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

800 Rose St
Lexington, KY 40536-7001
Phone (859) 257-1000

Hospital & facility affiliations

  • University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
78.19
Promoting interoperability
100
Improvement activities
40
Cost
70.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
119587NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Oct 1, 2021 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Mar 1, 2021 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

7 Southwoods Blvd
Ste 4
Albany, NY 12211

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

739 Irving Ave
Ste 420
Syracuse, NY 13210
Phone (315) 470-7921

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

725 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1023526522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 CASE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132092511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405361603",
            "telephone_number": "859-323-5956",
            "fax_number": "859-323-1080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Irving Ave",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101603",
            "country_code": "US",
            "telephone_number": "315-470-8705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTOTSKY",
        "first_name": "JOHN",
        "middle_name": "STEPAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-18",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "119587",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3016423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.