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Deactivated NPI 1003869637 Deactivated / Inactive NPI Male Practitioner

Mario Potvin

Surgery • Rochester, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mario Potvin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 17, 2006
NPI Deactivation Date December 19, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Mario Potvin was a registered Surgery practicing in Rochester, MN. Throughout an active medical career spanning 18 years, Mario Potvin provided care at the practice location at 210 9TH ST SE until profile deactivation on 2024-12-19.

Historical Medicare Part B clinical services included moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, new patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

210 9th St Se

Rochester, MN 559046425

Telephone 5072883443
Associated Practice Facility / Clinic
🏢 Olmsted Medical Center Facility NPI 1952356297

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Rochester, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.2 Yrs
State Avg: 23.0 Yrs
Regional Practice Density
216 Specialists

Practicing in Rochester, MN (770 Statewide)

Telehealth Adoption Rate
6.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
98.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito
11 11 $253.82 $4.98

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License MN 38741

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Lawrence Peterson

Psychiatry & Neurology - Psychiatry

NPI 1013961622
Dr. Graham Ritts , MD

Orthopaedic Surgery

NPI 1023013539

Doctor of Medicine (M.D.)

NPI 1023151495

Licensed Independent Clinical Social Worker

Saul Kissin , APRN, CNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1023375227

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Jack Perrone

Obstetrics & Gynecology

NPI 1033163365
NPI 1063909174

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
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NPI Profile Deactivated December 19, 2024

Record deactivated on December 19, 2024

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Updated Practice Location March 04, 2021

Registered at 3001 SANFORD PKWY, THIEF RIVER FALLS, MN 567012700 (Tel: 2186814747)

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Updated Business Mailing Address March 04, 2021

Registered at 2211 PRINCETON AVE, SAINT PAUL, MN 551051122 (Tel: 6517694530)

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Provider Name / Credentials Updated March 04, 2021

Recorded as MARIO POTVIN, MD

NPI Profile Active September 20, 2011

NPI status registered as active in NPPES database

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Updated Practice Location September 20, 2011

Registered at 210 9TH ST SE, ROCHESTER, MN 559046425 (Tel: 5072883443)

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Updated Business Mailing Address September 20, 2011

Registered at 210 9TH ST SE, ROCHESTER, MN 559046425 (Tel: 5072883443)

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Provider Name / Credentials Updated September 20, 2011

Recorded as MARIO POTVIN

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2011

Surgery (License #38741 in MN)

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Initial NPI Registration & Enumeration May 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003869637
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 17, 2006
Last Update: September 20, 2011
Deactivation Date: December 19, 2024

Mailing Address

210 9th St Se

Rochester, MN 559046425

Phone: 5072883443

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.