Individual provider Active NPI

Tracey Potter, LCSW

  • Social Worker
  • Elkton, MD
National Provider Identifier
1568022770
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
21214 Issued in MD
Practice address
111 W High St Ste 204
Elkton, MD 21921-8611
Phone
(410) 620-0008
NPI assigned
Jun 19, 2019
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21214 MD Primary

Addresses

Primary practice location

111 W High St Ste 204
Elkton, MD 21921-8611

Mailing address

PO Box 7356
Lancaster, PA 17604-7356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220518000615 MD Practitioner - Clinical Social Worker 7618354358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Practice addresses (Care Compare)

111 W High St
Suite 204
Elkton, MD 21921-8611
Phone (410) 620-0008

Merit-based Incentive Payment System (MIPS)

Final score
78.57 of 100Reported as group
Quality
59.34
Promoting interoperability
89
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21214MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince May 11, 2022 Accepting new patients
Union Hospital of Cecil County CurrentSince May 11, 2022 Accepting new patients

Locations

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

111 W High St
Ste 204
Elkton, MD 21921
Phone (410) 392-3007

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1568022770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7356",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176047356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W HIGH ST STE 204",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219218611",
            "telephone_number": "410-620-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "TRACEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.