DR. JAIRO ALFREDO FORTICH (M.D.) – Family Medicine Physician, NPI 1104867381

DR. JAIRO ALFREDO FORTICH (M.D.) is a healthcare provider. based in Knoxville, Tennessee. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 40307 (TN). The NPI Number for DR. JAIRO ALFREDO FORTICH (M.D.) is 1104867381

Main info

Male
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. JAIRO ALFREDO FORTICH (M.D.)
NPI
1104867381
Phone
(865) 212-2211
Address
8848 CEDAR SPRINGS LN
Enumeration Date
9 June 2006
Last Update Date
23 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6065464175
Graduation Year
1997 (29 years ago)
PAC ID
9638100282
Group Practice PAC ID
8123923679
Professional Enrollment ID
I20120703000210
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DR. JAIRO ALFREDO FORTICH (M.D.)

  • 8848 CEDAR SPRINGS LN

    SUITE 201

    KNOXVILLE, TN 379235415

    Phone: (865) 212-2211

    Fax: (865) 313-2149

    Type: Mailing

  • 140 MARKET PLACE BLVD STE E

    KNOXVILLE, TN 379222337

    Phone: (865) 212-2211

    Fax: (833) 314-0589

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $37.

Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: ABBVIE INC. ($23).

Total Amount

$37

General + Research + Ownership

Payments

2

Total payment records

General Amount

$37

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2012-07-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060413000624IFamily PracticeTNTBD
I20120703000210IEmergency MedicineKYTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making292282$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only148146$0
99284Emergency department visit with moderate level of medical decision making115113$0
99291Critical care, first 30-74 minutes3535$0
99283Emergency department visit with low level of medical decision making1313$0
View full utilization report →

Insurance plans in this area (ZIP 37923)

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Provider's Procedures

DR. JAIRO ALFREDO FORTICH (M.D.) performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINETN93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report161154

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8123923679View full group profile

Reviews

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Frequently asked questions

What federal number belongs to DR. JAIRO ALFREDO FORTICH (M.D.)?
The federal identifier for DR. JAIRO ALFREDO FORTICH (M.D.) is NPI 1104867381.
Does this profile mean DR. JAIRO ALFREDO FORTICH (M.D.) is currently active?
Yes — DR. JAIRO ALFREDO FORTICH (M.D.) appears active in the national provider directory.
What does DR. JAIRO ALFREDO FORTICH (M.D.) treat or focus on?
Patients typically see DR. JAIRO ALFREDO FORTICH (M.D.) under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DR. JAIRO ALFREDO FORTICH (M.D.)'s primary listing?
We display Knoxville, Tennessee because that is what the record indicates for DR. JAIRO ALFREDO FORTICH (M.D.).
Is DR. JAIRO ALFREDO FORTICH (M.D.) a real provider?
This page reflects official NPPES data for NPI 1104867381. Always confirm identity and privileges with the practice and licensing boards.

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