Ms Kathryn Suzanne Potts, is a medicare enrolled "Social Worker - Clinical" provider in Moreno Valley, California. Her current practice location is
13115 Kentland Ln, Moreno Valley, California. You can reach out to her office (for appointments etc.) via phone at
(909) 762-2648.
Ms Kathryn Suzanne Potts is licensed to practice in California (license number LCSW82169) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1558701961.
Healthcare Provider's Profile
Full Name | Ms Kathryn Suzanne Potts |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 13115 Kentland Ln, Moreno Valley, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1558701961
- Provider Enumeration Date: 06/29/2013
- Last Update Date: 09/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 3971986175
- Enrollment ID: I20220822001381
Medical Identifiers
Medical identifiers for Ms Kathryn Suzanne Potts such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1558701961 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 62984 (California) | Secondary |
1041C0700X | Social Worker - Clinical | LCSW82169 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Kathryn Suzanne Potts allows following entities to bill medicare on her behalf.
Entity Name | Thriveworks Clinical - California Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1801481395 PECOS PAC ID: 1759785645 Enrollment ID: O20220421000008 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kathryn Suzanne Potts is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ms Kathryn Suzanne Potts, 13115 Kentland Ln, Moreno Valley, CA 92553-4283 Ph: (909) 762-2648 | Ms Kathryn Suzanne Potts, 13115 Kentland Ln, Moreno Valley, CA 92553-4283 Ph: (909) 762-2648 |
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