Lynn A. Wanderer-Potter, PA-C
NPI 1174633994ActiveIndividual· Physician Assistant· Peoria, AZ
Physician Assistant (PA-C) with Active Vital Care LLC, practicing in Peoria, Arizona. Their prescriptions cost Medicare Part D more than their services did: $241,688 for 2,011 claims, against $5,821 paid for services in 2024.
Overview
| NPI | 1174633994 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Aug 30, 2006 |
| Last updated in NPPES | Aug 8, 2022 |
| Certified by provider | Aug 8, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 7762 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (AZ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 21 |
|---|---|
| Services billed | 77 across 6 procedure codes |
| Paid by Medicare | $5,821 |
Part D prescriptions in 2024
| Prescriptions (claims) | 2,011 · 3,663 30-day fills |
|---|---|
| Patients | 93 |
| Total drug cost | $241,688 |
| Generic share | 84% of claims |
Education and affiliations
| Graduation year | 1970 |
|---|---|
| Medicare specialty | Physician Assistant |
| Telehealth | Offers telehealth |
Medical group
- Active Vital Care LLCPhoenix, AZ · 21 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 114 physician assistants in Peoria · All physician assistants in Arizona