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MICHAEL W POTTER MD
NPI 1124004403
Surgery in Worcester, MA

Active since December 19, 2005PECOS EnrolledAccepts Medicare Assignment
123 SUMMER ST, SUITE 210, WORCESTER, MA 01608(508) 368-3190(508) 368-3985 Get Directions Write a Review

NPPES record last updated: May 21, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Michael W Potter Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL W POTTER MD (NPI 1124004403) is an individual surgery provider in Worcester, Massachusetts, licensed in Massachusetts (160784) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of University Of Massachusetts Medical School (1997).

NPPES Registry Identity

NPI1124004403
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMICHAEL W POTTERCredential: MD
Location Address123 SUMMER ST, SUITE 210Worcester, MA 01608-1312
Mailing Address5 Neponset St Fl Center12Worcester, MA 01606-2714 · (508) 368-3190 · Fax (508) 368-3985
Phone(508) 368-3190
Fax(508) 368-3985
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 1997
Enumeration DateDecember 19, 2005
Last NPPES UpdateMay 21, 2024
NPPES CertifiedMay 21, 2024
✔ NPI 1124004403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MA · 160784
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
123 SUMMER ST, Worcester, MA 01608
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Other Identifiers 18

Other2023718Cigna Health Plan
Other3208125Medicaid Welfare
Other7985198Aetna Us Healthcare
Medicaid3208125MA
Other419312Tufts Health Plan
Other784068Mvp Health Care
Other2230931First Health
Other784069Mvp Health Care
OtherJ22264Blue Care Elect
Other04 2472266Private Healthcare Syst.
Other04 2472266One Health Plan
Other04 2472266Three Rivers
Other70438Childrens Medical
Other70438Healthy Start
OtherJ22264Blue Shield Hmo Blue
OtherAA16160Harvard Pilgrim Health
Other60679Fallon Community Health
OtherA37468Medicare B

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael W Potter Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608842315
PECOS Enrollment IDI20040903000549
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
55 services55 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
25 services23 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
25 services23 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
22 services22 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
16 services16 patients
Repair of groin hernia using an endoscope 49650
This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Vincent Hospital

Acute Care Hospitals · Worcester, MA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number220176
Location123 Summer StreetWorcester, MA 01608 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01608 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADAIAH LOKESHWARI M.D.
Hospitalist
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-6849
DR. JENNIFER LYNNE PAPPALARDO DPM
Podiatrist (Foot & Ankle Surgery)
123 SUMMER ST, DEPARTMENT OF PODIATRY
WORCESTER, MA 01608
Worcester County (508) 363-7390
DR. MADHAV SHARMA MD
Internal Medicine
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5438
YESHASWINI KATKOORI MD
Student in an Organized Health Care Education/Training Program
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5000
DANIELLE MAY PELOQUIN
Nurse Anesthetist, Certified Registered
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5000
DR. YAYAN CHEN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-6049
FARRICY & KRAFT LLP
Obstetrics & Gynecology (Obstetrics)
123 SUMMER ST, SUITE 560
WORCESTER, MA 01608
Worcester County (508) 363-6100
KEITH A BEALS PA
Physician Assistant
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Potter's NPI number?

The NPI number for Michael Potter is 1124004403. It was assigned to this individual provider in the NPPES registry on December 19, 2005.

Where is Michael Potter located?

Michael Potter practices at 123 Summer St Suite 210, Worcester, MA 01608. The listed phone number is (508) 368-3190.

What is Michael Potter's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Michael Potter enrolled in Medicare?

Yes. Michael Potter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Potter accept?

Health plans from Anthem Blue Cross and Blue Shield list Michael Potter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michael Potter affiliated with any hospitals?

According to CMS data, Michael Potter is affiliated with St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Michael Potter was last updated on May 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.