NPIMap

Individual provider Active NPI

Matthew Edwards Potter, DO

  • Family Medicine Physician
  • Santa Maria, CA
National Provider Identifier
1063971240
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20003 Issued in CA
Practice address
235 S Palisade Dr
Santa Maria, CA 93454-5948
Phone
(805) 739-3561
Fax
(805) 739-3560
NPI assigned
Mar 18, 2019
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20003 CA Primary
Family Medicine Physician 207Q00000X 11839167-1204 UT

Addresses

Primary practice location

235 S Palisade Dr
Santa Maria, CA 93454-5948

Mailing address

235 S Palisade Dr
Santa Maria, CA 93454-5948
Phone (805) 739-3561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221003001175 CA Practitioner - Family Practice 4789009770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2801 Santa Maria Way
Santa Maria, CA 93455-2118

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast, Inc CurrentSince Sep 12, 2022 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Sep 12, 2022 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Beaver Valley Hospital Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients

Locations

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

2801 Santa Maria Way
Santa Maria, CA 93455
Phone (805) 934-5400

2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200

Interoperability endpoints

  • Direct secure messaging: matthew.potter.1@17363.direct.athenahealth.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 3

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1063971240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S PALISADE DR",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545948",
            "telephone_number": "805-739-3561",
            "fax_number": "805-739-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S PALISADE DR",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545948",
            "telephone_number": "805-739-3561",
            "fax_number": "805-739-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "MATTHEW",
        "middle_name": "EDWARDS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20003",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11839167-1204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.