Jason K Potter, M.D., D.D.S.

Primary specialty

SpecialistTaxonomy code 174400000X

License

M6345 Issued in TX

Practice address

8220 Walnut Hill LN
Suite 206
Dallas, TX 75231-4427

Phone

(214) 930-6588

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Plastic and Reconstructive SurgeryAlso: Maxillofacial Surgery, Oral Surgery

Education

University of Texas Southwestern Medical School at Dallas, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jason K Potter MD DDS PAGroup PAC ID 2466511688, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
• Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
• Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpotter@direct.uspi.com

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.

• Jason K Potter MD DDS PA

  • Specialist
  • Dallas, TX
  • NPI 1164608709
  Medicare reassignment Care Compare group NPD Authorized official
• Dermatology and Plastic Surgery Specialists PLLC

  • Plastic Surgery Physician
  • Southlake, TX
  • NPI 1043096365
  NPD Authorized official
• Pediatric Plastic Surgery, PLLC

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
  • NPI 1558419358
  NPD (past)

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

• Baylor Medical Center at Waxahachie

  • General Acute Care Hospital
  • Waxahachie, TX
  • NPI 1265430177
  Care Compare affiliation
• Baylor Regional Medical Center at Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1649273434
  Care Compare affiliation
• Bir JV LLP

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1538465901

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1467449207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93982",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920119",
            "telephone_number": "214-930-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 WALNUT HILL LN",
            "address_2": "SUITE 206",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314427",
            "telephone_number": "214-930-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "JASON",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D., D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OR",
            "license": "MD25735",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "M6345",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "M6345",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269840",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pothos Health
• Wendi Shanahan Pothukanuri, FNP
• Bridgette Renee Potier, PHARM D
• Whitney Kristina Potomac, D.O.
• Dana Potter, M.D.
• Jennifer Bailey Potter, PA
• John Michael Potter, D.M.D.
• Kimberly M Potter, BCBA LBA LBS
• Paul Stephen Potter, MSW
• Potters House Family Clinic LLC

• Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.
• 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.