Michael Scott Pottieger, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062762 Issued in PA

Practice address

100 E Lancaster Avenue
Medical Science BLDG Suite 275
Wynnewood, PA 19096

Phone

(610) 642-1908

Fax

(610) 642-6806

NPI assigned

Sep 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1154090603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 BRANDYWINE RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102610",
            "telephone_number": "610-406-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVENUE",
            "address_2": "MEDICAL SCIENCE BLDG SUITE 275",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "19096",
            "telephone_number": "610-642-1908",
            "fax_number": "610-642-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTIEGER",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sebastiano Porcu, MD
• Gail Cherise Porter
• Klarina Portnoy, M.D.
• David Posocco, MD
• Chadley Potter, PA-C
• Bruce Edward Powell, BS
• Pradeep Lothe MD PC
• Sarah Elizabeth Prehn, DDS
• Thomas Preis, CRNA
• Meghan Presley, CRNP

• Physician Assistant in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.