Jyothi V Thota, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

125047019 Issued in IL

Practice address

675 W North Ave
Suite 101
Melrose Park, IL 60160-1634

Phone

(708) 681-7670

Fax

(708) 681-7672

NPI assigned

Feb 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jthota277084@direct.northshore.org

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.

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  NPD

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1205808102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE 101",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-681-7670",
            "fax_number": "708-681-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE 101",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-681-7670",
            "fax_number": "708-681-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOTA",
        "first_name": "JYOTHI",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125047019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jthota277084@direct.northshore.org",
            "affiliation": "N",
            "address_1": "675 W North Ave",
            "address_2": "Suite 101",
            "city": "Melrose Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601601634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.