Active NPI
Susan B Potter, PA-C
- Medical Physician Assistant
- Citrus Heights, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10542
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
- Mercy San Juan Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.64 of 100
- Quality
- 86.27
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10542 | CA | MD | Medical Physician Assistant |
| 10542 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dignity Health Medical Foundation | Current | 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.
-
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1700803418
-
- Home Health Agency
- Woodland, CA
- NPI 1851494231
-
- Multi-Specialty Clinic/Center
- Rancho Cordova, CA
- NPI 1568489268
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sacramento, CA
- NPI 1487694857
-
- General Acute Care Hospital
- Carmichael, CA
- NPI 1972541498
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.