Individual provider Active NPI

Tracie Ilene Potis, MD

  • Emergency Medicine Physician
  • Saginaw, MI
National Provider Identifier
1356538318
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301086001 Issued in MI
Practice address
1000 Houghton Ave
Saginaw, MI 48602-5303
Phone
(989) 583-6910
Fax
(989) 583-7436
NPI assigned
Oct 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301086001 MI Primary

Addresses

Primary practice location

1000 Houghton Ave
Saginaw, MI 48602-5303

Mailing address

1000 Houghton Ave
Saginaw, MI 48602-5303
Phone (989) 583-6910

Other identifiers 1

IdentifierTypeStateIssuer
5315033621OtherMICONTROLLED SUBSTANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tpotismd1519@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080109000084 MI Practitioner - Emergency Medicine 1153401740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nebraska College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

900 Cooper Ave
Saginaw, MI 48602-5182
Phone (989) 583-6521

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. CurrentSince Jul 1, 2008 Accepting new patients
Covenant Medical Center, Inc. Emergency Medicine Current Accepting new patients
Covenant Medical Center, Inc CurrentSince Jul 1, 2008 Accepting new patients

Locations

2770 Main St
Marlette, MI 48453
Phone (989) 635-4000

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

Interoperability endpoints

  • Direct secure messaging: tpotismd1519@direct.covenanthealthcare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1356538318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025303",
            "telephone_number": "989-583-6910",
            "fax_number": "989-583-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025303",
            "telephone_number": "989-583-6910",
            "fax_number": "989-583-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTIS",
        "first_name": "TRACIE",
        "middle_name": "ILENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301086001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "5315033621",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpotismd1519@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "1000 Houghton Ave",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486025303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.