Corrine Potter, PMH-NP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Worcester, Massachusetts. Her current practice location is
19 Tacoma St, Worcester, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(508) 852-1805.
Corrine Potter is licensed to practice in Massachusetts (license number RN2266298) 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 1255880175.
Healthcare Provider's Profile
| Full Name | Corrine Potter |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 19 Tacoma St, Worcester, Massachusetts |
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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: 1255880175
- Provider Enumeration Date: 10/04/2016
- Last Update Date: 03/21/2018
Medicare PECOS Information:
- PECOS PAC ID: 7810245412
- Enrollment ID: I20180730000930
Medical Identifiers
Medical identifiers for Corrine Potter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1255880175 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | RN2266298 (Massachusetts) | 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. Corrine Potter allows following entities to bill medicare on her behalf.
| Entity Name | Edward M Kennedy Community Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609842152 PECOS PAC ID: 3476512740 Enrollment ID: O20041004000840 |
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| Entity Name | Supportive Behavioral Care Of Ma Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780115519 PECOS PAC ID: 8628346731 Enrollment ID: O20170614000877 |
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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. Corrine Potter 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 |
Corrine Potter, PMH-NP 650 Lincoln St, Worcester, MA 01605-2060 Ph: () - | Corrine Potter, PMH-NP 19 Tacoma St, Worcester, MA 01605-3516 Ph: (508) 852-1805 |
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