Individual provider Active NPI

Kyle B Potts, MD

  • Surgery Physician
  • Visalia, CA
National Provider Identifier
1811965221
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G64819 Issued in CA
Practice address
805 W Acequia Ave
Suite 2-a
Visalia, CA 93291-6162
Phone
(559) 738-0450
Fax
(559) 738-0460
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G64819 CA Primary

Addresses

Primary practice location

805 W Acequia Ave
Suite 2-a
Visalia, CA 93291-6162

Mailing address

805 W Acequia Ave
Suite 2-a
Visalia, CA 93291-6162
Phone (559) 738-0450

Other identifiers 1

IdentifierTypeStateIssuer
1265651756MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20031215000376 CA Practitioner - General Surgery 1456258037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

805 W Acequia Ave
Suite 2a
Visalia, CA 93291-6164
Phone (559) 738-0450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.18 of 100Reported as individual
Quality
98.89
Promoting interoperability
100
Improvement activities
40
Cost
87.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy54
Melanoma (skin cancer) excision29

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kyle B. Potts, M.D., Inc. CurrentSince Jul 2, 2003 Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Mineral King Surgical Associates, Inc. Surgery Past Accepting new patients

Locations

15725 Pomerado Rd
Ste 203
Poway, CA 92064
Phone (858) 675-0883

805 W Acequia Ave
Ste 2A
Visalia, CA 93291
Phone (559) 738-0450

Organizations & group practices 3

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 2

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1811965221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W ACEQUIA AVE",
            "address_2": "SUITE 2-A",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916162",
            "telephone_number": "559-738-0450",
            "fax_number": "559-738-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W ACEQUIA AVE",
            "address_2": "SUITE 2-A",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916162",
            "telephone_number": "559-738-0450",
            "fax_number": "559-738-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "KYLE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G64819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265651756",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.