John Owen Tully, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

35.097547 Issued in OH

Practice address

7580 Northcliff Ave Ste 1000
Brooklyn, OH 44144-3271

Phone

(440) 808-1212

Fax

(440) 808-0321

NPI assigned

Jan 24, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Gastroenterology

Education

Jefferson Medical College of Thomas Jefferson University, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Shore Gastroenterology, Inc.Group PAC ID 3072409382, 24 clinicians

North Shore Pathology LLCGroup PAC ID 8527224567, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
• Lutheran Hospital Hospital, Cleveland, OH, CCN 360087
• Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155
• Parma Community General Hospital Hospital, Parma, OH, CCN 360041

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtully37550@ehrdirect.uhhospitals.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.

• North Shore Gastroenterology, Inc.

  • Gastroenterology Physician
  • Westlake, OH
  • NPI 1932121050
  Medicare reassignment Care Compare group NPD
• North Shore Pathology LLC

  • Clinical Medical Laboratory
  • Westlake, OH
  • NPI 1245591965
  Medicare reassignment Care Compare group NPD
• North Shore Endoscopy Center

  • Gastroenterology Physician
  • Westlake, OH
  • NPI 1467474585
  NPD

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

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017
  Care Compare affiliation
• Lutheran Hospital

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1194763045
  Care Compare affiliation
• Parma Community General Hospital Association

  • General Acute Care Hospital
  • Parma, OH
  • NPI 1164481677
  Care Compare affiliation
• Southwest General Health Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1154353993
  Care Compare affiliation

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1265619993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD",
            "address_2": "STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "216-767-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 NORTHCLIFF AVE STE 1000",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "441443271",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Columbia Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441457215",
            "country_code": "US",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLY",
        "first_name": "JOHN",
        "middle_name": "OWEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-24",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.097547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050898",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00992476",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Taylor, PHARMD
• Karena Antoinette Taylor
• The Cleveland Clinic Foundation
• Gwendolyn Thomas
• Kelly Treanor
• Tonyetta Marie Turner
• Dennis Mitchell Tustan, O.D.
• Jessica D Ule
• United Cerebral Palsy Association of Greater Cleveland, Inc.
• Visionworks Inc

• Gastroenterology Physician in Brooklyn, OH
• Providers in Brooklyn, OH by specialty
• Gastroenterology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.