Individual provider Active NPI

Ryan Potter, AU.D.

  • Audiologist
  • Syracuse, NY
National Provider Identifier
1396976155
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002224 Issued in NY
Practice address
1001 James St
Syracuse, NY 13203-2707
Phone
(315) 428-0016
Fax
(315) 478-3913
NPI assigned
Jul 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002224 NY Primary

Addresses

Primary practice location

1001 James St
Syracuse, NY 13203-2707

Mailing address

1001 James St
Syracuse, NY 13203-2707
Phone (315) 428-0016

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130131000094 NY Practitioner - Qualified Audiologist 4183878002 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002224NYMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC CurrentSince Dec 13, 2017 Accepting new patients
Audiology Services Company USA, LLC Audiologist CurrentSince Dec 13, 2017 Accepting new patients

Locations

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

5320 W Genesee St
Ste 300
Camillus, NY 13031
Phone (315) 234-3842

240 W Seneca St
Ste 3
Manlius, NY 13104
Phone (315) 682-2025

106 W Utica St
Ste B
Oswego, NY 13126
Phone (315) 341-5873

58 S Main St
Sayville, NY 11782
Phone (631) 750-6376

1001 James St
Syracuse, NY 13203
Phone (315) 428-0016

Organizations & group practices 2

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1396976155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032707",
            "telephone_number": "315-428-0016",
            "fax_number": "315-478-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032707",
            "telephone_number": "315-428-0016",
            "fax_number": "315-478-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "RYAN",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.