Active NPI
W Mark Potampa, M.D.
- Ophthalmology Physician
- Kirkland, WA
National Provider Identifier
1922085646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD00023322
- Practice address
- 11919 NE 128TH St
Suite a
Kirkland, WA 98034-7204 - Phone
- (425) 821-6655
- Fax
- (425) 821-8836
- NPI assigned
- Dec 22, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD00023322 | WA | Primary |
Addresses
Primary practice location
11919 NE 128TH St
Suite a
Kirkland, WA 98034-7204
Mailing address
1101 Madison St
Suite 600
Seattle, WA 98104-1306
Phone (206) 215-2004
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180021811 | Other | RAILROAD MEDICARE | |
| 0071123 | Other | WA | LABOR & INDUSTRIES |
| 8307290 | Medicaid | WA | |
| PO3997 | Other | REGENCE HEALTHCARE |
Other names 1
- Whitton M Potampa
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00023322 | WA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219276800000",
"number": "1922085646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 MADISON ST",
"address_2": "SUITE 600",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041306",
"telephone_number": "206-215-2004",
"fax_number": "206-215-2055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11919 NE 128TH ST",
"address_2": "SUITE A",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980347204",
"telephone_number": "425-821-6655",
"fax_number": "425-821-8836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTAMPA",
"first_name": "W",
"middle_name": "MARK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2008-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WA",
"license": "MD00023322",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180021811",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0071123",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8307290",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE HEALTHCARE",
"identifier": "PO3997",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "WHITTON",
"last_name": "POTAMPA",
"middle_name": "M",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.