Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jordan Richard Pothast, PA

Individual provider Physician Assistant · NPI 1194125120

Jordan Richard Pothast, PA is a Physician Assistant in Lima, Ohio. Qualified in 2014, 12 years ago. Practices with Extended Care Specialists, Inc, a 290-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
12
Licensed in
OH
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

730 W Market St
Lima, OH 45801-4602
Phone: (192) 273-3614
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.006748RX (OH)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 50.006748RX (OH)

Record details

NPI number1194125120
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 27, 2014
Last updated in NPPESAugust 20, 2021
Certification dateAugust 20, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Extended Care Specialists, Inc — 290 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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