DR. THADDEUS J POTOCKI DC
NPI 1154446417
Chiropractor in Fair Oaks, CA

Q: What is Thaddeus Potocki's NPI number?

The NPI number for Thaddeus Potocki is 1154446417. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Q: What is Thaddeus Potocki's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Thaddeus Potocki was last updated on October 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since March 19, 2007

5150 SUNRISE BLVD, SUITE F1, FAIR OAKS, CA 95628(916) 536-0400(916) 344-8523 Get Directions Write a Review

NPPES record last updated: October 30, 2008. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Dr. Thaddeus J Potocki Dc NPPES

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

DR. THADDEUS J POTOCKI DC (NPI 1154446417) is an individual chiropractor in Fair Oaks, California, licensed in California (DC020349) and active in the NPI registry since March 2007. He is a graduate of Life Chiropractic College - West (1989).

NPPES Registry Identity

NPI1154446417

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameDR. THADDEUS J POTOCKICredential: DC

Location Address5150 SUNRISE BLVD, SUITE F1Fair Oaks, CA 95628-4939

Mailing Address5150 Sunrise Blvd, Suite F1Fair Oaks, CA 95628-4939 · (916) 536-0400 · Fax (916) 344-8523

Phone(916) 536-0400

Fax(916) 344-8523

Sole ProprietorNo

Medical School CMSLife Chiropractic College - WestGraduated 1989

Enumeration DateMarch 19, 2007

Last NPPES UpdateOctober 30, 2008

✔ NPI 1154446417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in CA · DC020349

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

5150 SUNRISE BLVD, Fair Oaks, CA 95628

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Other Identifiers 1

Medicare UPINDC0203490CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thaddeus J Potocki Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7810056330

PECOS Enrollment IDI20081112000402

Medicare Billing Reassignment

Medicare enrollment records show Thaddeus Potocki reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Potocki Family Chiropractic And Laser Center Inc

Same address

Chiropractor

5150 SUNRISE BLVD, STE. F1
Fair Oaks, CA 95628

Reassigned Medicare billing, California enrollment

NPI 1578848701 (916) 536-0400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

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

RENEE HARRELL ASW

Social Worker

5150 SUNRISE BLVD, SUITE G5
FAIR OAKS, CA 95628

Sacramento County (916) 965-3807

COMMUNITY COUNSELING ASSOCIATES

Counselor (Mental Health)

5150 SUNRISE BLVD, SUITE H-1
FAIR OAKS, CA 95628

Sacramento County (916) 565-5015

POTOCKI FAMILY CHIROPRACTIC AND LASER CENTER INC

Chiropractor

5150 SUNRISE BLVD, STE. F1
FAIR OAKS, CA 95628

Sacramento County (916) 536-0400

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 Thaddeus Potocki's NPI number?

The NPI number for Thaddeus Potocki is 1154446417. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Where is Thaddeus Potocki located?

Thaddeus Potocki practices at 5150 Sunrise Blvd Suite F1, Fair Oaks, CA 95628. The listed phone number is (916) 536-0400.

What is Thaddeus Potocki's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Thaddeus Potocki enrolled in Medicare?

Yes. Thaddeus Potocki is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Thaddeus Potocki's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thaddeus Potocki reassigns Medicare benefits to Potocki Family Chiropractic And Laser Center Inc (Fair Oaks, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thaddeus Potocki's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Thaddeus Potocki was last updated on October 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.