Stephanie Ross Potts, PHD
Individual provider Active NPI Clinical Neuropsychologist · Oshkosh, WI
NPI 1144873159 · NPPES record last updated Sep 10, 2024
Key facts
- NPI
- 1144873159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Neuropsychologist 103G00000X
- License
- 5131 (WI)
- Practice address
- 700 N Westhaven Dr
Oshkosh, WI 54904-6947 - Phone
- (920) 456-2030
- NPI assigned
- Jul 18, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Medical Group, Inc.
Practice addresses (Care Compare)
700 N Westhaven Dr
Oshkosh, WI 54904-6947
Phone (920) 303-8700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MO, IL, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191002000135 | MO | Practitioner - Clinical Psychologist | 1254661432 | Reassigns benefits to 1 organization |
| I20230530002046 | IL | Practitioner - Clinical Psychologist | 1254661432 | |
| I20240305000850 | WI | Practitioner - Clinical Psychologist | 1254661432 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
700 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 456-2030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2018013237 | MO | |
| Psychologist | 103T00000X | 071.010747 | IL | |
| Clinical Neuropsychologist | 103G00000X | 5131 | WI | Yes |
| Clinical Neuropsychologist | 103G00000X | 071.010747 | IL | |
| Clinical Neuropsychologist | 103G00000X | 2018013237 | MO |
Addresses
Primary practice location
700 N Westhaven Dr
Oshkosh, WI 54904-6947
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
1451 Merchant Dr
Algonquin, IL 60102-5917
Phone (847) 469-7537
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100266414 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | spotts393563@direct.myadvocateaurora.org | Direct |
Other providers in Oshkosh, WI
- Danielle J Pontius
- Ellie F Popp
- John William Poss
- Marlee Potratz
- Loren M. Potter
- Stacie K Pouh
- Powerback Rehab
- Valerie A. Prajka
- Denise M Prehn
- Premise Health of Wisconsin Medical S C
All providers in Oshkosh, WI · Clinical Neuropsychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.