Individual provider Active NPI

Susan B Potter, PA-C

  • Medical Physician Assistant
  • Citrus Heights, CA
National Provider Identifier
1871694166
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10542 Issued in CA
Practice address
7115 Greenback LN
FL 3
Citrus Heights, CA 95621-6133
Phone
(916) 536-3540
Fax
(916) 536-2455
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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 PA10542 CA Primary

Addresses

Primary practice location

7115 Greenback LN
FL 3
Citrus Heights, CA 95621-6133

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080711000486 CA Practitioner - Physician Assistant 3173695814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

Hospital & facility affiliations

  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
  • Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10542CAMDMedical Physician Assistant
10542CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 17, 1995 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

6555 Coyle Ave
Carmichael, CA 95608
Phone (916) 536-2500

7115 Greenback Ln
Fl 3
Citrus Heights, CA 95621
Phone (916) 536-3540

7115 Greenback Ln
Fl 2
Citrus Heights, CA 95621
Phone (916) 536-3620

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

8120 Timberlake Way
Sacramento, CA 95823
Phone (408) 998-5551

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1871694166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 GREENBACK LN",
            "address_2": "FL 3",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956216133",
            "telephone_number": "916-536-3540",
            "fax_number": "916-536-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "SUSAN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA10542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

Verify at the official NPI Registry.