Individual provider Active NPI

David A Potter, M.D.

  • Hematology & Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1073579504
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
49214 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 273-8383
NPI assigned
Apr 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 01052675 IN
Hematology & Oncology Physician 207RH0003X 49214 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

420 Delaware St SE
MMC 480
Minneapolis, MN 55455-0341
Phone (612) 625-8933

Other practice location 1

420 Delaware St SE
MMC 480
Minneapolis, MN 55455-0341
Phone (612) 625-8933

Other identifiers 1

IdentifierTypeStateIssuer
200295760MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20070129000490 MN Practitioner - Surgical Oncology 2769483080 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Johns Hopkins University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01052675INMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 15, 2023 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jan 15, 2023 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince May 1, 2010 Accepting new patients
Fairview Express Care CurrentSince May 1, 2010 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

909 Fulton St SE
Ste 202
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

420 Delaware St SE
#480
Minneapolis, MN 55455
Phone (612) 624-0123

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

Interoperability endpoints

  • Direct secure messaging: dpotter147830@fairview.direct-ci.com

Organizations & group practices 10

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 4

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": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1073579504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 480",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-8933",
            "fax_number": "612-624-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-273-8383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE",
            "address_2": "MMC 480",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550341",
            "country_code": "US",
            "telephone_number": "612-625-8933",
            "fax_number": "612-624-1443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01052675",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "49214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200295760",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.