NPIMap

Individual provider Active NPI

Jay Fuletra

  • Urology Physician
  • Media, PA
National Provider Identifier
1295268878
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD469411 Issued in PA
Practice address
200 E State St Ste 205
Media, PA 19063-3434
Phone
(610) 565-2776
NPI assigned
Apr 10, 2017
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD469411 PA Primary

Addresses

Primary practice location

200 E State St Ste 205
Media, PA 19063-3434

Mailing address

140 W Germantown Pike Ste 200
Plymouth Meeting, PA 19462-1421
Phone (484) 530-0205

Other practice location 1

500 Evergreen Dr Ste G5
Glen Mills, PA 19342-1032
Phone (610) 565-2776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220604000042 PA Practitioner - Urology 5991183840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

211 S Gulph Rd
Suite 200 the Prostate Center
King of Prussia, PA 19406-3101
Phone (610) 579-3577

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.14 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
67.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
Alliance Physician Services, PC Urology CurrentSince Jan 2, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
Alliance Physician Services, PC Urology CurrentSince Jan 2, 2023 Accepting new patients
Alliance Physician Services, PC Urology Past Accepting new patients
Alliance Physician Services, PC Urology Past Accepting new patients

Locations

500 Evergreen Dr
Ste G5
Glen Mills, PA 19342
Phone (610) 566-4383

211 S Gulph Rd
Ste 200
Kng of Prussa, PA 19406
Phone (610) 382-5910

200 E State St
Ste 205
Media, PA 19063
Phone (610) 521-4112

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

800 Walnut St
Fl 19
Philadelphia, PA 19107
Phone (215) 829-3409

140 W Germantown Pike
Ste 200
Plymouth Meeting, PA 19462

656 E Swedesford Rd
Ste 120
Wayne, PA 19087
Phone (610) 273-5320

Organizations & group practices 7

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

Hospital & facility affiliations 3

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1295268878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W GERMANTOWN PIKE STE 200",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621421",
            "telephone_number": "484-530-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E STATE ST STE 205",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633434",
            "telephone_number": "610-565-2776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Evergreen Dr Ste G5",
            "address_purpose": "LOCATION",
            "city": "Glen Mills",
            "state": "PA",
            "postal_code": "193421032",
            "country_code": "US",
            "telephone_number": "610-565-2776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULETRA",
        "first_name": "JAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD469411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.