Jerome R Potozkin MD, a Professional Corporation

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G73505 Issued in CA

Legal business name

JEROME R POTOZKIN MD, A PROFESSIONAL CORPORATION

Practice address

600 San Ramon Valley Blvd
Suite 102
Danville, CA 94526-4014

Phone

(925) 385-8980

Fax

(925) 838-4920

NPI assigned

Mar 5, 2007

Last updated

Sep 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Potozkin, M.D.NPI 1184635195

Title

Owner

Phone

(925) 838-4900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 9

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.

• Jerome Potozkin, MD

  • Dermatology Physician
  • Danville, CA
  • NPI 1184635195
  Medicare reassignment Care Compare group Authorized official
• Charlene Boatright, FNP

  • Family Nurse Practitioner
  • Danville, CA
  • NPI 1477133130
  Medicare reassignment Care Compare group NPD
• Samantha Rose Ellis, M.D.

  • Dermatology Physician
  • Danville, CA
  • NPI 1174918098

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Barry A. Waldman, MD

  • Dermatology Physician
  • Martinez, CA
  • NPI 1760560825
  Medicare reassignment Care Compare group NPD
• Tomi Lee Wall, MD

  • Dermatology Physician
  • Oakland, CA
  • NPI 1417947060
  Medicare reassignment Care Compare group NPD
• Jennifer Kushnier, PA-C

  • Physician Assistant
  • Danville, CA
  • NPI 1437518909
  Medicare reassignment Care Compare group
• Heather Marie Nudo, PA

  • MOHS-Micrographic Surgery Physician
  • Walnut Creek, CA
  • NPI 1518077411
  Medicare reassignment Care Compare group
• Nicole Mariah Rivas, PA-C

  • Physician Assistant
  • Danville, CA
  • NPI 1356206502
  Medicare reassignment
• Jessica Lynn Vlasek, PA-C

  • Physician Assistant
  • Reno, NV
  • NPI 1770880361

  CA

  Medicare reassignment

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1093844292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SAN RAMON VALLEY BLVD",
            "address_2": "SUITE 102",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264014",
            "telephone_number": "925-385-8980",
            "fax_number": "925-838-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SAN RAMON VALLEY BLVD",
            "address_2": "SUITE 102",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264014",
            "telephone_number": "925-385-8980",
            "fax_number": "925-838-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME R POTOZKIN MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "POTOZKIN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-838-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G73505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Ann Jayan, M.D.
• Charlotte Jefford
• David Lee Jeha
• William Brian Jeha, RPH
• Audrey Jeon Jeon
• Kim Jespersen, PT
• Matthew Patrick Jewik
• Jhona Marie Jingco
• Joey Nguyen, DDS, Inc.
• Johnson Chiropractic Group, Inc.

• Dermatology Physician in Danville, CA
• Providers in Danville, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.