Individual provider Active NPI

Kristina L Potsko, PA-C

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1619159175
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056039 Issued in PA
Practice address
1250 S Cedar Crest Blvd
Suite 310
Allentown, PA 18103-6224
Phone
(610) 402-6890
Fax
(610) 402-6892
NPI assigned
Nov 27, 2007
Last updated
Dec 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 002029 CT
Physician Assistant 363A00000X MA056039 PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd
Suite 310
Allentown, PA 18103-6224

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20130509000491 PA Practitioner - Physician Assistant 4082704713 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd
Phila, PA 19141-3018

5501 Old York Rd Levy 2
Einstein Pediatrics Associates
Philadelphia, PA 19141-3018
Phone (215) 456-6786

5501 Old York Rd WCB 4TH FLR
Einstein CT Surgery Assoc
Philadelphia, PA 19141-3018
Phone (215) 456-8270

559 W Germantown Pike
East Norriton, PA 19403-4250

609 W Germantown Pike
East Norriton, PA 19403-4250

Einstein Surgical Assocs
700 West Germantown Pike
East Norriton, PA 19403-4250
Phone (484) 622-7800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2029CTMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jun 17, 2013 Accepting new patients
Einstein Practice Plan, Inc. CurrentSince Aug 27, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 17, 2013 Accepting new patients
Einstein Practice Plan Inc CurrentSince Aug 27, 2019 Accepting new patients
Geisinger Clinic CurrentSince Jul 6, 2015 Accepting new patients
Geisinger Clinic CurrentSince Jul 6, 2015 Accepting new patients
Hartford Clinical Associates, P.C. Physician Assistant Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

1210 S Cedar Crest Blvd
Ste 3300
Allentown, PA 18103
Phone (610) 402-8506

1250 S Cedar Crest Blvd
Ste 310
Allentown, PA 18103
Phone (610) 402-6890

100 N Academy Ave
Danville, PA 17822

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1619159175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD",
            "address_2": "SUITE 310",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-402-6890",
            "fax_number": "610-402-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTSKO",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "002029",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.