JAISE THEKKAN POULOSE (M.D.) – Critical Care Medicine (Internal Medicine) Physician, NPI 1497872675
Critical Care Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
251 CRITICAL CARE (INTENSIVISTS) in KY
Provider Addresses for JAISE THEKKAN POULOSE (M.D.)
PO BOX 635283
CINCINNATI, OH 452635283
Phone: (859) 757-2927
Fax: (859) 341-0203
Type: Mailing
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 410173403
Phone: (859) 757-2927
Fax: (859) 341-0203
Type: Location
1202 LOUISIANA AVE
SHREVEPORT, LA 711013910
Phone: (318) 212-8546
Type: Mailing
3000 32ND AVE S
FARGO, ND 581036132
Phone: (701) 364-8000
Fax: (701) 364-8078
Type: Location
PO BOX 2400
HOPKINSVILLE, KY 422412400
Phone: (270) 887-0100
Type: Mailing
320 W 18th St
Hopkinsville, KY 422401965
Phone: (270) 887-0100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $200.
Total Amount is formed as General ($200) + Research ($0) + Ownership ($0) = $200.
Last reported payment date: 2024-12-05 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($185).
Total Amount
$200
General + Research + Ownership
Payments
9
Total payment records
General Amount
$200
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $185 |
| Inspire Medical Systems, Inc. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-07-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200710002790 | I | Critical Care (Intensivists) | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 120 | 36 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 89 | 37 | $0 |
| 99291 | Critical care, first 30-74 minutes | 47 | 33 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 29 | 29 | $0 |
| 36556 | Insertion of non-tunneled central venous tube for infusion (5 years or older) | 15 | 13 | $0 |
Insurance plans in this area (ZIP 45263)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CRITICAL CARE (INTENSIVISTS) | ND | 36620 | Insertion of arterial catheter for blood sampling or infusion, accessed through the skin | 14 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | KY | |
| Physician Assistant | TN | |
| Internal Medicine | KY | |
| Internal Medicine | KY | |
| Certified Registered Nurse Anesthetist (Crna) | KY | |
| Certified Registered Nurse Anesthetist (Crna) | TN | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Certified Registered Nurse Anesthetist (Crna) | KY | |
| Certified Registered Nurse Anesthetist (Crna) | KY |
Reviews
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