Individual provider Active NPI

Iordan Potchileev, DO

  • Anesthesiology Physician
  • Miami, FL
National Provider Identifier
1477057974
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036166015 Issued in IL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 585-1111
NPI assigned
Mar 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OS19155 FL
Anesthesiology Physician 207L00000X 036166015 IL Primary
Anesthesiology Physician 207L00000X 81811-21 WI

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Other practice location 1

800 W. Central Rd.
Department of Anesthesia
Arlington Heights, IL 60005-2349
Phone (847) 618-7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231208002791 IL Practitioner - Anesthesiology 6800272964 Reassigns benefits to 2 organizations
I20250807002214 WI Practitioner - Anesthesiology 6800272964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-Wisconsin Anesthesia SCGroup PAC ID 2163968819, 144 clinicians
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2301 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1132

2650 Ridge Ave
Evanston, IL 60201-1700

800 W Central Rd
Arlington Heights, IL 60005-2349
Phone (847) 618-1000

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS19155FLMDAnesthesiology Physician
036166015ILMDAnesthesiology Physician
81811-21WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Wisconsin Anesthesia SC Anesthesiology CurrentSince Jul 28, 2025 Accepting new patients
Endeavor Health Medical Group Anesthesiology Current Accepting new patients
Vituity-Wisconsin Anesthesia SC Anesthesiology CurrentSince Jul 28, 2025 Accepting new patients
Endeavor Health Medical Group Anesthesiology CurrentSince Feb 5, 2025 Accepting new patients
Midwest Anesthesiologists, LTD. Anesthesiology CurrentSince Oct 31, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

3407 Momentum Pl
Chicago, IL 60689

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Organizations & group practices 5

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 4

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1477057974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W. Central Rd.",
            "address_2": "Department of Anesthesia",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600052349",
            "country_code": "US",
            "telephone_number": "847-618-7140",
            "fax_number": "847-618-0228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTCHILEEV",
        "first_name": "IORDAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS19155",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036166015",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "81811-21",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.