Jesus Presto Querubin Jr., MD
Individual provider Active NPI Internal Medicine Physician · Greenup, KY
NPI 1609965375 · NPPES record last updated Feb 10, 2015
Key facts
- NPI
- 1609965375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 33412 (KY)
- Practice address
- 401 US 23
Greenup, KY 41144-1074 - Phone
- (606) 473-1501
- Fax
- (606) 473-1503
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
401 US
Suite 23
Greenup, KY 41144-1074
Phone (606) 473-1501
Hospital & facility affiliations
- King'S Daughters' Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 32 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031106000591 | KY | Practitioner - Internal Medicine | 4981517927 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellefonte Medical Center Inc | Internal Medicine | Current |
Accepting new patients |
Locations
401 US 23
Greenup, KY 41144
Phone (606) 225-6072
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72412
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 33412 | KY | Yes |
Addresses
Primary practice location
401 US 23
Greenup, KY 41144-1074
Mailing address
PO Box 828
Greenup, KY 41144-1074
Phone (606) 473-1501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017990 | Medicaid | OH | |
| P00060046 | Other | RR MEDICARE | |
| 64332141 | Medicaid | KY |
Other providers in Greenup, KY
- Mary Palmer
- William Palmer
- Martha Jane Patrick
- Stephen Matthew Perkey
- Qualls Family Chiropractic Inc.
- R Brooks Callihan DMD PSC
- Trina Randall
- Kaylie Rase
- Red 8 Medical PLLC
- Red 8 RX LLC
All providers in Greenup, KY · Internal Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.