Individual provider Active NPI

Kathleen Potesta

  • Medical Physician Assistant
  • Frederick, MD
National Provider Identifier
1811365539
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1562 Opossumtown Pike
Frederick, MD 21702-4920
Phone
(240) 215-6310
Fax
(240) 566-7754
NPI assigned
Sep 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1562 Opossumtown Pike
Frederick, MD 21702-4920

Mailing address

400 W 7TH St
Frederick, MD 21701-4506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151208001388 MD Practitioner - Physician Assistant 5597065961 Reassigns benefits to 2 organizations
I20171226000941 DC Practitioner - Physician Assistant 5597065961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Frederick Health Way
Frederick, MD 21701-9435
Phone (240) 215-6310

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

1562 Opossumtown Pike
Suite 301
Frederick, MD 21702-4926
Phone (240) 215-6310

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727-8929
Phone (240) 215-6310

194 Thomas Johnson Dr
Frederick, MD 21702-4679
Phone (240) 215-6310

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 215-6310

501 W 7TH St
Suite 104
Frederick, MD 21701-5096
Phone (240) 215-6310

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

7211 Bank CT
Frederick, MD 21703-8482
Phone (240) 215-6310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries, LLC CurrentSince Oct 21, 2017 Accepting new patients
MNR Industries, LLC CurrentSince Jun 1, 2017 Accepting new patients
MNR Industries, LLC CurrentSince Jun 1, 2017 Accepting new patients
Frederick Health Medical Group LLC CurrentSince Mar 19, 2025 Accepting new patients
Frederick Health Medical Group LLC CurrentSince Mar 19, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
MNR Industries LLC Past Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

1562 Opossumtown Pike
Frederick, MD 21702
Phone (240) 566-4500

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1811365539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 OPOSSUMTOWN PIKE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024920",
            "telephone_number": "240-215-6310",
            "fax_number": "240-566-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTESTA",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.