NPIMap

Individual provider Active NPI

Jeremy Potter, PA

  • Orthopaedic Surgery Physician
  • Meadville, PA
National Provider Identifier
1861464075
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MA051202 Issued in PA
Practice address
11277 Vernon Place
Suite 200
Meadville, PA 16335-3717
Phone
(814) 724-1252
Fax
(814) 333-8871
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MA051202 PA Primary

Addresses

Primary practice location

11277 Vernon Place
Suite 200
Meadville, PA 16335-3717

Mailing address

11277 Vernon Place
Suite 200
Meadville, PA 16335-3717
Phone (814) 724-1252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329000673 PA Practitioner - Physician Assistant 2567418932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, 493 clinicians
Orthopedic Associates of Meadville, P.C.Group PAC ID 0446151864, 17 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, 750 clinicians

Practice addresses (Care Compare)

1012 Water St
Meadville, PA 16335-3468
Phone (814) 337-2345

11277 Vernon PL
Suite 200
Meadville, PA 16335-3719
Phone (814) 724-1252

316 Allegheny Blvd
Suite B
Franklin, PA 16323-6208
Phone (814) 432-7200

Hospital & facility affiliations

  • Meadville Medical Center Hospital, Meadville, PA, CCN 390113
  • Titusville Area Hospital Hospital, Titusville, PA, CCN 391314

National Provider Directory

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

Organizations & group practices 31

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.

View all 31

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1861464075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11277 VERNON PLACE",
            "address_2": "SUITE 200",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353717",
            "telephone_number": "814-724-1252",
            "fax_number": "814-333-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11277 VERNON PLACE",
            "address_2": "SUITE 200",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353717",
            "telephone_number": "814-724-1252",
            "fax_number": "814-333-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "JEREMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MA051202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.