Lourdes Bernadette Verdera Potestades, PT, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23535 Issued in MD

Practice address

5 N la Plata CT Ste 102
La Plata, MD 20646-5207

Phone

(301) 609-5494

Fax

(301) 392-6109

NPI assigned

Oct 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Civista Medical Center IncGroup PAC ID 7618864976, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Civista Medical Center Inc

  • Rural Acute Care Hospital
  • La Plata, MD
  • NPI 1992701825
  Medicare reassignment Care Compare group NPD
• Civista Medical Center, Inc.

  • Physical Therapist
  • La Plata, MD
  • NPI 1689071219
  NPD
• Civista Medical Center, Inc.

  • Clinical Medical Laboratory
  • La Plata, MD
  • NPI 1801461926
  NPD
• Medpro

  • Physical Therapist
  • Fort Lauderdale, FL
  • NPI 1033353339
  NPD (past)

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1053590125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 PRESTANCIA PL APT 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206024124",
            "telephone_number": "443-538-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 N LA PLATA CT STE 102",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206465207",
            "telephone_number": "301-609-5494",
            "fax_number": "301-392-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTESTADES",
        "first_name": "LOURDES BERNADETTE",
        "middle_name": "VERDERA",
        "name_prefix": "Miss",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P11371",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Pherson, LCPC
• Kerry Erin Pinkham, FNP-BC
• Usman Ghani Piracha, MD
• Heather Lynn Pirl, MS CCC-SLP
• Jalen Poindexter
• Faith Potoeski, M.S., CCC-SLP
• Potomac Internal Medicine and Pediatrics,LLC.
• Potomac Pain and Rehabilitation Associates, LLC
• Precision Orthopedics and Sports Medicine
• Precision Orthopedics and Sports Medicine

• Physical Therapist in La Plata, MD
• Providers in La Plata, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.