Daedly Potusek, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8133 Issued in CT

Practice address

2200 Whitney Ave Ste 290
Hamden, CT 06518-3695

Phone

(203) 903-8308

Fax

(203) 599-3927

NPI assigned

Mar 14, 2019

Sex

Female

Sole proprietor

No

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.

• Anchor Health Initiative Corp.

  • Primary Care Clinic/Center
  • Stamford, CT
  • NPI 1245773191

  CT

  Medicare reassignment Care Compare group NPD
• New Leaf Psychiatry LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hamden, CT
  • NPI 1063139202

  CT

  Medicare reassignment Authorized official
• Anchor Health Initiative Corp.

  • Community/Retail Pharmacy
  • Stamford, CT
  • NPI 1518425578
  Care Compare group NPD

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Anchor Health Initiative Corp. 11 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 20, 2024.

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1578022166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 WHITNEY AVENUE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WHITNEY AVE STE 290",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183695",
            "telephone_number": "203-903-8308",
            "fax_number": "203-599-3927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Phoenix Ave",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067021418",
            "country_code": "US",
            "telephone_number": "203-756-8021 x3529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTUSEK",
        "first_name": "DAEDLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "8133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pop-Up Pediatrics, LLC
• Rosemary Porter
• Jillian Porto
• Lori Sue Porzio, RPH
• Stephen E Possick, M.D.
• Dayshan Olivia Pouncey-Muhammad, CNA
• Jennie Pratt, LMSW
• Anna J Predmore, OTR/L
• Lindsey Renee Preo, APRN
• Tyanna Lashawn Preston

• All providers in Hamden, CT
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.