DR. DOUGLAS A POTOKA MD
NPI 1518932698
Specialist in Pittsburgh, PA
NPI Status: Active since February 22, 2006
Contact Information
3705 5TH AVE
CHILDREN'S HOSPITAL, 48485
PITTSBURGH, PA
ZIP 15213
Phone: (412) 692-7280
- Individual
- Male
- Specialist
- Accepts Insurance
- PECOS Enrolled
About DOUGLAS POTOKA
This page provides the complete NPI Profile along with additional information for Douglas Potoka, a provider established in Pittsburgh, Pennsylvania with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1518932698 assigned on February 2006. The practitioner's primary taxonomy code is 174400000X with license number MD074039L (PA). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1518932698
- Provider Name
- DR. DOUGLAS A POTOKA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3705 5TH AVE CHILDREN'S HOSPITAL, 48485 PITTSBURGH, PA 15213
- Location Phone
- (412) 692-7280
- Mailing Address
- 3705 5TH AVE CHILDREN'S HOSPITAL, 48485 PITTSBURGH, PA 15213
- Mailing Phone
- (412) 692-7280
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 02-22-2006
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- MD074039L
- License State
- PA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze $8,300 w/ Adult Dental ON-EX - HMO
- Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
- Bronze HSA $7,300 ON-EX - HMO
- Bronze Standard w/ Virtual & Wellness - HMO
- Gold $1,000 w/ Adult Dental ON-EX - HMO
- Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
- Gold $500 w/ Virtual & Wellness ON-EX - HMO
- Gold Standard w/ Virtual & Wellness - HMO
- Silver $5,000 w/ Adult Dental ON-EX - HMO
- Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
- Silver $5,800 w/ Virtual & Wellness ON-EX - HMO
- Silver Standard w/ Virtual & Wellness - HMO
- SummaCare Bronze 10600 with 3 Free PCP Visits - HMO
- SummaCare Bronze 10600 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Bronze 8000 - HMO
- SummaCare Bronze 8000 with Adult Vision Exam - HMO
- SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 3500 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits - HMO
- SummaCare Silver 6000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 7000 with 3 Free PCP Visits - HMO
- SummaCare Standard Bronze - HMO
- SummaCare Standard Bronze with Adult Vision - HMO
- SummaCare Standard Gold - HMO
- SummaCare Standard Gold with Adult Vision - HMO
- SummaCare Standard Silver - HMO
- SummaCare Standard Silver with Adult Vision - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Gold Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 091516FKY | MEDICARE ID-TYPE UNSPECIFIED (04) | PA | |
| I30738 | MEDICARE UPIN (02) | PA |
Medicare Participation & PECOS Enrollment Status
Douglas Potoka is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for DR. DOUGLAS A POTOKA MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1518932698, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PITTSBURGH, PA 15213
PITTSBURGH, PA 15213
PITTSBURGH, PA 15213
PITTSBURGH, PA 15213
PITTSBURGH, PA 15213
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1518932698, enumerated as an "individual" on February 22, 2006.
The provider is located at 3705 5TH AVE CHILDREN'S HOSPITAL, 48485 PITTSBURGH, PA 15213 and the phone number is (412) 692-7280.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: MedMutual, SummaCare, UnitedHealthcare, Medicare. Please consult your insurance carrier or call the provider to verify.
