Active NPI
Sean Victor Pottenger, CRNA
- Certified Registered Nurse Anesthetist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2024004459
- Practice address
- 1 Barnes Jewish Hospital PLZ
Dept Anesthesiology
Saint Louis, MO 63110-1003 - Phone
- (800) 862-9980
- Fax
- (314) 362-1185
- NPI assigned
- Jul 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2024004459 | MO | Primary |
Addresses
Primary practice location
1 Barnes Jewish Hospital PLZ
Dept Anesthesiology
Saint Louis, MO 63110-1003
Mailing address
PO Box 60352
Saint Louis, MO 63160-0352
Phone (800) 862-9980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 910136728 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011
4860 Y St
Sacramento, CA 95817-2307
4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525
4868 X St
Sacramento, CA 95817-2205
500 W Hospital Rd
French Camp, CA 95231-9693
Phone (209) 468-6600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024004459 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the Univ of Ca | Current | Accepting new patients | |
| Regents of the Univ of Ca | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| San Joaquin Faculty Medical Group | Current | Accepting new patients | |
| County of San Joaquin | Current | Accepting new patients | |
| County of San Joaquin | Current | Accepting new patients | |
| Regents of the Univ of Ca | Current | Accepting new patients |
Locations
500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000
2315 Stockton Blvd
Ste 1200
Sacramento, CA 95817
Phone (916) 734-5394
2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030
4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700
Organizations & group practices 6
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.
-
- Maternal & Fetal Medicine Physician
- Sacramento, CA
- NPI 1013906973
-
- Internal Medicine Physician
- French Camp, CA
- NPI 1225063761
-
- General Acute Care Hospital
- French Camp, CA
- NPI 1801830583
-
- Multi-Specialty Clinic/Center
- Manteca, CA
- NPI 1417407636
-
- Certified Registered Nurse Anesthetist
- Sacramento, CA
- NPI 1235122342
Nurse Anesthetist, Certified Registered
-
- Diagnostic Radiology Physician
- Sacramento, CA
- NPI 1477546406
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- French Camp, CA
- NPI 1992870430
-
- General Acute Care Hospital
- Sacramento, CA
- NPI 1710918545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1346813557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60352",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631600352",
"telephone_number": "800-862-9980",
"fax_number": "314-362-1185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BARNES JEWISH HOSPITAL PLZ",
"address_2": "DEPT ANESTHESIOLOGY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101003",
"telephone_number": "800-862-9980",
"fax_number": "314-362-1185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTENGER",
"first_name": "SEAN",
"middle_name": "VICTOR",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-23",
"last_updated": "2024-04-25",
"certification_date": "2021-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2024004459",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "910136728",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "1 Barnes Jewish Hospital Plz",
"address_2": "Dept Anesthesiology",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.