Jerry Varghese Thuthikattu John, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

325117 Issued in NY

Practice address

15 S Main St Ste 150
Jamestown, NY 14701-6627

Phone

(716) 483-6700

Fax

(716) 664-7275

NPI assigned

Jul 29, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willcare Chha (Buffalo) Home health agency, Buffalo, NY, CCN 337268
• Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
• Chautauqua Hospice and Palliative Care Hospice, Lakewood, NY, CCN 331554
• Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerry.john@upmcdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Lakes Physician Practice PC

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1730599176

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Jamestown Area Medical Associates, L.L.P.

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1528010766
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Chautauqua Hospice and Palliative Care

  • Community Based Hospice Care Agency
  • Lakewood, NY
  • NPI 1639255250
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jamestown, NY
  • NPI 1568023687
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • General Acute Care Hospital
  • Jamestown, NY
  • NPI 1770573222
  Care Compare affiliation
• Visiting Nursing Association of Western New York, Inc.

  • Home Health Agency
  • Cheektowaga, NY
  • NPI 1730268384
  Care Compare affiliation
• Western Region Health Corporation

  • Home Health Agency
  • Amherst, NY
  • NPI 1710036298
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1053920504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W VILLARD AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532094901",
            "telephone_number": "414-527-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST STE 150",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016627",
            "telephone_number": "716-483-6700",
            "fax_number": "716-664-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JERRY",
        "middle_name": "VARGHESE THUTHIKATTU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "77253-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "325117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer K Wilcox Nurse Practitioner in Family Health PC
• Cameron Elizabeth Jernigan, D.O.
• Carrie E Jessey, M.S.
• Tony Jiang
• Justine Marie Jock
• Allison Johnson
• Amber Lynn Johnson, RN
• Anastasia Marie Johnson, PTA
• Andrea Johnson
• Christina Kathleen Johnson, LPN

• Family Medicine Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.