Individual provider Active NPI

Stephanie Pottinger, MD

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1780211367
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
325583 Issued in NY
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-4321
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 325583 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226003902 NY Practitioner - Psychiatry 0840635124 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325583NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 16, 2024 Accepting new patients
New York University CurrentSince Jan 16, 2024 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: spottinger457371@nyumc.direct-ci.com
  • Direct secure messaging: spottinger1340784@nychhc.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1780211367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTINGER",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "325583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.