Individual provider Active NPI

Jacquelyn Potesta

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
National Provider Identifier
1689116311
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
373899 Issued in OH
Practice address
10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone
(513) 865-1111
NPI assigned
Nov 11, 2016
Last updated
Jan 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 373899 OH Primary
Registered Nurse 163W00000X 373899 OH

Addresses

Primary practice location

10500 Montgomery Rd
Cincinnati, OH 45242-4402

Mailing address

9891 Montgomery Rd # 340
Cincinnati, OH 45242-6424

Other names 1

  • Jacquelyn Mountel Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170220002594 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820371701 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
373899OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 26, 2020 Accepting new patients
Cgi Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2021 Accepting new patients
Resource Anesthesia Highlands Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 26, 2024 Accepting new patients
Outpatient Anesthesia Specialists CurrentSince Mar 15, 2024 Accepting new patients
West Chester Surgical Suites, LLC Past Accepting new patients
Tri State Urologic Services PSC Inc PastSince Nov 3, 2024 Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

4746 Montgomery Rd
Cincinnati, OH 45212
Phone (513) 731-5600

7661 Beechmont Ave
Cincinnati, OH 45255
Phone (513) 233-4900

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

4200 Indian Ripple Rd
Dayton, OH 45440
Phone (937) 320-5050

75 Sylvania Dr
Dayton, OH 45440
Phone (937) 320-5050

9000 N Main St
Ste 405
Englewood, OH 45415
Phone (937) 320-5050

1275 N High St
Hillsboro, OH 45133
Phone (937) 393-5503

2000 Joseph E Sanker Blvd
Norwood, OH 45212
Phone (513) 841-7400

4700 Smith Rd
Norwood, OH 45212
Phone (513) 366-3400

2601 Far Hills Ave
Oakwood, OH 45419
Phone (937) 298-1093

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

Organizations & group practices 7

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": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1689116311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9891 MONTGOMERY RD # 340",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452426424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-865-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTESTA",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "373899",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "373899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "MOUNTEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.