MARK S POTENZA MD NPI 1134122096

NPI Information

  • NPI: 1134122096
  • Provider Name: MARK S POTENZA, MD
  • Classification: Surgery - 2086S0122X
  • Specialization: Plastic and Reconstructive Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5700 W GENESEE ST
    STE 132
    CAMILLUS, NY
    ZIP 13031
  • Phone: (315) 487-5858

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NPI Details

Mark S Potenza, MD is a plastic and reconstructive surgery surgery in Camillus, NY with 41 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. Mark S Potenza, MD NPI is 1134122096. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduation Year:1985

The provider's business location address is:

5700 W GENESEE ST
STE 132
CAMILLUS, NY
ZIP 13031-212
Phone: (315) 487-5858
Fax: (315) 487-1950

The NPI 1134122096 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:11312)
  • Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11302)
  • Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm (HCPCS:11307)
  • Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm (HCPCS:11311)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:11442)
  • Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:11642)
  • Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
  • Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm (HCPCS:12052)
  • Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm (HCPCS:11441)
  • Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm (HCPCS:11301)
  • Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11602)
  • Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm (HCPCS:11643)
  • Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11402)
  • Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm (HCPCS:11422)
  • Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm (HCPCS:11622)
  • Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm (HCPCS:11401)
  • Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less (HCPCS:11310)
  • Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm (HCPCS:11604)
  • Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm (HCPCS:11306)
  • Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm (HCPCS:13121)
  • Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm (HCPCS:17283)
  • Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11603)
  • Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm (HCPCS:11641)
  • Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm (HCPCS:11623)
  • Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less (HCPCS:11440)
  • Shaving of skin growth of body, arms, or legs, more than 2.0 cm (HCPCS:11303)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm (HCPCS:13132)
  • Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm (HCPCS:12042)
  • Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm (HCPCS:17284)
  • Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm (HCPCS:11644)
  • Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm (HCPCS:11421)
  • Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm (HCPCS:17273)
  • Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm (HCPCS:13152)
  • Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm (HCPCS:11313)
  • Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11403)
  • Destruction of cancer skin growth of trunk, arms, or legs, 3.1-4.0 cm (HCPCS:17264)
  • Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm (HCPCS:11308)
  • Complicated repair of wound of trunk, 2.6-7.5 cm (HCPCS:13101)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 5/24/2005 and was last updated on 12/20/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0122XSurgeryPlastic and Reconstructive Surgery167600NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F31752MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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