Individual provider Active NPI

Meredith Jane Potrzebowski, D.O.

  • Family Medicine Physician
  • Noblesville, IN
National Provider Identifier
1659662419
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02004072A Issued in IN
Practice address
210 N 10TH St Ste 30
Noblesville, IN 46060-2179
Phone
(765) 830-3538
Fax
(317) 567-3101
NPI assigned
Apr 28, 2011
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 73798 MN
Family Medicine Physician 207Q00000X 02004072A IN Primary

Addresses

Primary practice location

210 N 10TH St Ste 30
Noblesville, IN 46060-2179

Mailing address

210 N 10TH St Ste 30
Noblesville, IN 46060-2179
Phone (765) 830-3538

Other practice location 1

420 E 1st St
Duluth, MN 55805-1901
Phone (218) 786-8364

Other identifiers 2

IdentifierTypeStateIssuer
201133760MedicaidIN
P01424393OtherINRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 23, 2026 through Jan 23, 2028

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004072AINMDFamily Medicine Physician
73798MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD Current Accepting new patients
Major Hospital Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

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": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1659662419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N 10TH ST STE 30",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602179",
            "telephone_number": "765-830-3538",
            "fax_number": "317-567-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N 10TH ST STE 30",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602179",
            "telephone_number": "765-830-3538",
            "fax_number": "317-567-3101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051901",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTRZEBOWSKI",
        "first_name": "MEREDITH",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "73798",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02004072A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201133760",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01424393",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

Verify at the official NPI Registry.