Individual provider Active NPI

William Potocnik, OTR/L

  • Occupational Therapist
  • Worcester, MA
National Provider Identifier
1174364046
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTL15380 Issued in MA
Practice address
799 W Boylston St Ste 7
Worcester, MA 01606-3071
Phone
(617) 738-5110
NPI assigned
Jun 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTL15380 MA Primary

Addresses

Primary practice location

799 W Boylston St Ste 7
Worcester, MA 01606-3071

Mailing address

270 N Brookfield Rd
Barre, MA 01005-9186
Phone (487) 287-8472

Other names 1

  • William Potocnik Juenemann Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812000617 MA Practitioner - Occupational Therapist in Private Practice 2264970136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mab Community Services IncGroup PAC ID 3870570070, 12 clinicians

Practice addresses (Care Compare)

799 W Boylston St
Suite 7
Worcester, MA 01606-3071
Phone (585) 854-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mab Community Services, Inc Occupational Therapist CurrentSince Jul 10, 2024 Accepting new patients

Locations

200 Ivy St
Brookline, MA 02446
Phone (617) 738-5110

799 W Boylston St
Ste 7
Worcester, MA 01606
Phone (508) 854-0700

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1174364046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 N BROOKFIELD RD",
            "city": "BARRE",
            "state": "MA",
            "postal_code": "010059186",
            "telephone_number": "487-287-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 W BOYLSTON ST STE 7",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016063071",
            "telephone_number": "617-738-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTOCNIK",
        "first_name": "WILLIAM",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "OTL15380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "JUENEMANN",
            "middle_name": "POTOCNIK",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.