Tiffany R Pottkotter, CNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Upper Sandusky, Ohio. Her current practice location is
885 N Sandusky Ave, Upper Sandusky, Ohio. You can reach out to her office (for appointments etc.) via phone at
(419) 294-4991.
Tiffany R Pottkotter is licensed to practice in Ohio (license number APRN.CNP.16281) 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 1629271150.
Healthcare Provider's Profile
| Full Name | Tiffany R Pottkotter |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 885 N Sandusky Ave, Upper Sandusky, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1629271150
- Provider Enumeration Date: 06/11/2007
- Last Update Date: 03/06/2023
Medicare PECOS Information:
- PECOS PAC ID: 5092031088
- Enrollment ID: I20150310002524
Medical Identifiers
Medical identifiers for Tiffany R Pottkotter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629271150 | NPI | - | NPPES |
| 0111791 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | C0500689 (Ohio) | Secondary |
| 101YP2500X | Counselor - Professional | COA16281NP (Ohio) | Secondary |
| 363L00000X | Nurse Practitioner | COA16281-NP (Ohio) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | APRN.CNP.16281 (Ohio) | 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. Tiffany R Pottkotter allows following entities to bill medicare on her behalf.
| Entity Name | Wyandot Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477554475
PECOS PAC ID: 1557340189
Enrollment ID: O20040716001163 |
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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. Tiffany R Pottkotter 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 |
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Tiffany R Pottkotter, CNP
885 N Sandusky Ave,
Upper Sandusky, OH 43351-1098
Ph: (419) 294-4991 | Tiffany R Pottkotter, CNP
885 N Sandusky Ave,
Upper Sandusky, OH 43351-1098
Ph: (419) 294-4991 |
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