Jeny M. Pothen Itty, D.O

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

005304 Issued in AZ

Practice address

500 W Thomas Rd Ste 900a
Phoenix, AZ 85013-4223

Phone

(602) 406-3540

Fax

(602) 406-7186

NPI assigned

Jul 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Sjhmc Physician Services

  dba St. Joseph's Faculty Physicians

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005
  Medicare reassignment Care Compare group NPD
• St Josephs Pathology

  dba Pathology Associates LTD

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1265407738
  NPD
• St. Joseph's Hospital and Medical Center

  dba SJHMC Trauma Services

  • Emergency Care Clinic/Center
  • Phoenix, AZ
  • NPI 1255382412
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  dba St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park

  • Emergency Care Clinic/Center
  • Litchfield Park, AZ
  • NPI 1265065445

  Hospital

  Care Compare affiliation
• Dignity Health

  dba St. Josephs Hospital and Medical Center Emergency Dept-Glendale

  • Emergency Care Clinic/Center
  • Glendale, AZ
  • NPI 1609408665

  Hospital

  Care Compare affiliation
• Dignity Health

  dba St. Joseph's Hospital and Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1982733655
  Care Compare affiliation
• Dignity Health

  dba St. Joseph's Westgate Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1992131734
  Care Compare affiliation

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1922260702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 900A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134223",
            "telephone_number": "602-406-3540",
            "fax_number": "602-406-7186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2927 N 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134102",
            "country_code": "US",
            "telephone_number": "602-406-3153",
            "fax_number": "602-406-7176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTHEN ITTY",
        "first_name": "JENY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "005304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "455059",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Bradley Poston
• Tracy Sandford Poston, PAC
• Adelaide Cadence Pote
• Potential Zone: Pathways to Growth Inc.
• Stephanie Marie Poterack, FNP
• Jerrin Thomas Pothen, MD
• Madhavi Potluri, D.M.D
• Cheri M Pott, MD
• Amara Potter, COTA/L
• Clayton Potter

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.

Verify at the official NPI Registry.