Individual provider Active NPI

Joseph A Jestus, M.D.

  • Neurological Surgery Physician
  • Cookeville, TN
National Provider Identifier
1265411151
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
29172 Issued in TN
Practice address
105 S Willow Ave
Suite 200
Cookeville, TN 38501-3138
Phone
(931) 372-7716
Fax
(931) 525-1066
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 29172 TN Primary

Addresses

Primary practice location

105 S Willow Ave
Suite 200
Cookeville, TN 38501-3138

Mailing address

105 S Willow Ave
Cookeville, TN 38501-4667
Phone (931) 372-7716

Other identifiers 2

IdentifierTypeStateIssuer
Q013109MedicaidTN
3720925MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjestus@t1ortho.gwaydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20101015000450 TN Practitioner - Neurosurgery 2668554635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

105 S Willow Ave
Cookeville, TN 38501-4667
Phone (931) 526-9518

Hospital & facility affiliations

  • Cookeville Regional Home Health Home health agency, Cookeville, TN, CCN 447131
  • Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059
  • Cumberland Medical Center Hospital, Crossville, TN, CCN 440009
  • Livingston Regional Hospital Hospital, Livingston, TN, CCN 440187

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion144
Laminectomy or laminotomy (partial removal of spine bones)155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29172TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic PC CurrentSince Aug 1, 2022 Accepting new patients
Campbell Clinic, PC Neurological Surgery CurrentSince Aug 1, 2022 Accepting new patients
Campbell Clinic Past Accepting new patients
Cookeville Regional Medical Center Past Accepting new patients

Locations

105 S Willow Ave
Cookeville, TN 38501
Phone (931) 372-7716

105 S Willow Ave
Ste 100
Cookeville, TN 38501
Phone (931) 267-4929

335 W Spring St
Cookeville, TN 38501
Phone (931) 303-0446

105 S Willow Ave
Ste 200
Cookeville, TN 38501
Phone (931) 372-7716

35 Taylor Ave
Crossville, TN 38555
Phone (865) 483-8478

310 Oak St
Livingston, TN 38570
Phone (931) 403-0559

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • Direct secure messaging: joseph.jestus.1@1366.direct.athenahealth.com
  • Direct secure messaging: jjestus@t1ortho.gwaydirect.com
  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1265411151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014667",
            "telephone_number": "931-372-7716",
            "fax_number": "931-526-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "address_2": "SUITE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013138",
            "telephone_number": "931-372-7716",
            "fax_number": "931-525-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESTUS",
        "first_name": "JOSEPH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "29172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q013109",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3720925",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjestus@t1ortho.gwaydirect.com",
            "affiliation": "N",
            "address_1": "105 S Willow Ave",
            "address_2": "Suite 200",
            "city": "Cookeville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "385013138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.