Samuel J Potolicchio Jr., MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

D0042536 Issued in MD

Practice address

4940 Hampden LN Ste 300
Bethesda, MD 20814-2968

Phone

(301) 652-7155

Fax

(301) 246-8628

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, PA, VA, GA4 enrollments

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 4

Specialty

Neurology

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
• Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  • Cardiovascular Disease Physician
  • Marion, VA
  • NPI 1326159567
  Medicare reassignment NPD
• DLP Conemaugh Physician Practices LLC

  • Family Medicine Physician
  • Cresson, PA
  • NPI 1932515905
  Medicare reassignment NPD
• Mary Washington Healthcare Physicians

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1295999852

  Neurological Surgery

  Medicare reassignment NPD
• Phoenixville Clinic Company LLC

  • Family Medicine Physician
  • Phoenixville, PA
  • NPI 1891866182

  Neurology

  Medicare reassignment NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270

  Neurology

  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Neurology Physician
  • Abingdon, VA
  • NPI 1669793493
  NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• DLP Conemaugh Physician Practices LLC

  • Internal Medicine Physician
  • Johnstown, PA
  • NPI 1205242609
  NPD
• DLP Conemaugh Physician Practices LLC

  • Emergency Medicine Physician
  • Roaring Spring, PA
  • NPI 1245742188
  NPD
• Mary Washington Healthcare Physicians

  • Durable Medical Equipment & Medical Supplies
  • Fredericksburg, VA
  • NPI 1740853035
  NPD
• Phoenixville Clinic Company LLC

  • Vascular Surgery Physician
  • Limerick, PA
  • NPI 1790746345
  NPD

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

• Piedmont Newton Hospital, Inc.

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588
  Care Compare affiliation
• Piedmont Rockdale Hospital Inc.

  • General Acute Care Hospital
  • Conyers, GA
  • NPI 1306355680
  Care Compare affiliation

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1114993367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5214 ALBEMARLE ST",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208161829",
            "telephone_number": "301-602-2906",
            "fax_number": "301-246-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 HAMPDEN LN STE 300",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142968",
            "telephone_number": "301-652-7155",
            "fax_number": "301-246-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTOLICCHIO",
        "first_name": "SAMUEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101052485",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101052485",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MD",
            "license": "D0042536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Post
• Louise Yood Postman, M.D.
• Calvin Poston, PTA, CSCS
• Merrily Ann Poth, M.D.
• Latha Pothuri, CCC SLP
• Potomac Ambulatory Surgery Center
• Potomac Arthritis & Rheumatism Madalene K. Greene, MD, P.C.
• Potomac Vision Care
• Judith A. Potter, C.R.N.P.
• Mary Potthast, HS

• Neurological Surgery Physician in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Neurological Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.