Individual provider Active NPI

Jessica Potucek, APRN, FNP-BC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1689247173
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
842526 Issued in NV
Practice address
5510 S Fort Apache Rd
Las Vegas, NV 89148-7700
Phone
(702) 899-0100
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 842526 NV Primary

Addresses

Primary practice location

5510 S Fort Apache Rd
Las Vegas, NV 89148-7700

Mailing address

8631 Bando Dr
Las Vegas, NV 89148-5375
Phone (702) 913-3685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20221128000933 NV Practitioner - Nurse Practitioner 8729456611 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspacio Dermatology a Professional Corporation CurrentSince Aug 10, 2022 Accepting new patients
Arcadian LLC CurrentSince Jul 31, 2025 Accepting new patients
Global Wound Care Medical Group CurrentSince Feb 12, 2024 Accepting new patients
Mount Sinai Medical Center of Florida, Inc Past Accepting new patients

Locations

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

1700 E Desert Inn Rd
Ste 103
Las Vegas, NV 89169
Phone (702) 734-8511

5510 S Fort Apache Rd
Las Vegas, NV 89148
Phone (702) 604-2498

5510 S Fort Apache Rd
Ste 103
Las Vegas, NV 89148
Phone (702) 899-0100

8310 W Sahara Ave
Las Vegas, NV 89117
Phone (702) 243-4501

5550 S Fort Apache Rd
Ste 103
Las Vegas, NV 89148
Phone (702) 899-0100

4375 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 899-0100

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1689247173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 BANDO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485375",
            "telephone_number": "702-913-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487700",
            "telephone_number": "702-899-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTUCEK",
        "first_name": "JESSICA",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "842526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.