Nicole Potter

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

025698 Issued in NY

Practice address

819 S Salina St
Syracuse, NY 13202-3570

Phone

(153) 476-7921

Fax

(315) 234-3115

NPI assigned

Mar 30, 2020

Last updated

Aug 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Syracuse Community Health Center IncGroup PAC ID 0143121327, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npotter686085@direct.ochin.org

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.

• Syracuse Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Syracuse, NY
  • NPI 1497796353
  Medicare reassignment Care Compare group NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1841828514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BRAEMAR DR APT 15",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130904095",
            "telephone_number": "315-236-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023570",
            "telephone_number": "153-476-7921",
            "fax_number": "315-234-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2021-08-25",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.schcny.com",
            "affiliation": "N",
            "address_1": "819 S Salina St",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132023570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Valerie Potash, NP
• Dominica Potenza, LMHC, LPC, NCC
• Monica Potru, MBBS/M.D
• Ashley Potter
• Cassandra Nicole Potter
• Olivia Marie Potter, FNP
• Ryan Potter, AU.D.
• Aarati Poudel, MD
• Pradish Poudel, MD
• Bhavya Poudyal, M.B.B.S.

• Physician Assistant in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.