Individual provider Active NPI

Alicia Catherine Potes, PA-C

  • Physician Assistant
  • Watsonville, CA
National Provider Identifier
1861689911
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
204 E Beach St
Watsonville, CA 95076-4809
Phone
(831) 728-0222
Fax
(831) 707-2777
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CT Primary

Addresses

Primary practice location

204 E Beach St
Watsonville, CA 95076-4809

Mailing address

195 Aviation Way
Suite 200
Watsonville, CA 95076-2053
Phone (831) 728-8250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 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
I20140725001472 CA Practitioner - Nurse Practitioner 7113015348 Reassigns benefits to 1 organization
I20140820002461 CA Practitioner - Physician Assistant 7113015348 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21310CAMDMental Health Counselor
001916CTMDOncology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Para la Gente CurrentSince Jun 11, 2014 Accepting new patients
Salud Para la Gente CurrentSince Jun 11, 2014 Accepting new patients

Locations

195 Aviation Way
Ste 200
Watsonville, CA 95076

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

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.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1861689911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 AVIATION WAY",
            "address_2": "SUITE 200",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762053",
            "telephone_number": "831-728-8250",
            "fax_number": "831-707-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E BEACH ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764809",
            "telephone_number": "831-728-0222",
            "fax_number": "831-707-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTES",
        "first_name": "ALICIA",
        "middle_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.