Lydia Lee Potoma, PMHNP-BC

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

APRN.CNP.026685 Issued in OH

Practice address

12300 McCracken Rd
Garfield Heights, OH 44125-2914

Phone

(216) 587-8341

NPI assigned

Dec 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Justin W Havemann MD LLCGroup PAC ID 3072909514, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Justin W Havemann MD LLC

  • Psychiatry Physician
  • Rocky River, OH
  • NPI 1215206370
  Medicare reassignment Care Compare group NPD
• Psycho Social Therapies,LTD

  • Clinical Social Worker
  • Beachwood, OH
  • NPI 1750335261
  Medicare reassignment NPD
• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713
  Medicare reassignment NPD
• Lydia Potoma LLC

  • Psychiatry Physician
  • Middleburg Heights, OH
  • NPI 1659177699
  NPD Authorized official
• Psycho Social Therapies,LTD

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beachwood, OH
  • NPI 1902462906
  NPD
• Southwest General Health Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1154353993
  NPD (past)

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1558908400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 MCCRACKEN RD",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-587-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 MCCRACKEN RD",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-587-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTOMA",
        "first_name": "LYDIA",
        "middle_name": "LEE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-10",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "OH",
            "license": "APRN.CNP.026685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rozlyn Pinkins, LSW
• Rebecca Pinkston
• Barton Russell Poole, CNP
• Robin Poole
• Anna Popova, MSN, APRN, PMHNP-BC
• Aleatha Denise Powell
• Kia-Rai Michelle Prewitt, PHD
• Avery Price
• Stephanie Price
• Tiffany Frances Price, LPN

• Geriatric Psychiatry Physician in Garfield Heights, OH
• Providers in Garfield Heights, OH by specialty
• Geriatric Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.