DR. JOHN PYLMAN M.D.
NPI 1053560805
Hospitalist in Utica, NY

Active since September 17, 2008PECOS EnrolledAccepts Medicare Assignment
78.7/100
CMS Quality Rating
1656 CHAMPLIN AVE, UTICA, NY 13502(315) 624-6467 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 27, 2025, Nov 13, 2015 (2 updates tracked since 2015).

About Dr. John Pylman M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN PYLMAN M.D. (NPI 1053560805) is an individual hospitalist provider in Utica, New York, licensed in New York (271806) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS, is affiliated with Wynn Hospital, and maintains a secondary practice location in Utica.

NPPES Registry Identity

NPI1053560805
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameDR. JOHN PYLMANCredential: M.D.
Location Address1656 CHAMPLIN AVEUtica, NY 13502-4830
Mailing Address1656 Champlin AveUtica, NY 13502-4830
Sole ProprietorNo
Medical School CMSWashington University School Of MedicineGraduated 2008
Enumeration DateSeptember 17, 2008
Last NPPES UpdateApril 22, 20252 updates tracked since enumeration
NPPES CertifiedApril 22, 2025
NPI 1053560805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in NY · 271806
Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 149898 (NC)
1656 CHAMPLIN AVE, Utica, NY 13502

Secondary Practice Location 1

Location 1628 Mary St # AUtica, NY 13501-2419 · Phone (315) 272-2622

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. John Pylman M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072744465
PECOS Enrollment IDI20140328000245
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
539 services222 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
335 services173 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
153 services137 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
111 services103 patients
Nursing facility discharge management, more than 30 minutes 99316
Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
104 services101 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
102 services78 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wynn Hospital

Acute Care Hospitals · Utica, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330044
Location111 Hospital DriveUtica, NY 13502 · Oneida County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13502 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.73
Promoting Interoperability99
Improvement Activities40
Cost42.38

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
1 supplier11 claims11 services$47.39 avg. paid by Medicare
Walker, heavy duty, wheeled, rigid or folding, any type E0149
DME-Other DME · category DE000N
1 supplier18 claims18 services$9.23 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
1 supplier53 claims53 services$44.97 avg. paid by Medicare
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
3 suppliers37 claims37 services$39.59 avg. paid by Medicare
Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038
DME-Other DME · category DE000N
1 supplier11 claims11 services$7.70 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier57 claims57 services$16.05 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Surgery
1656 CHAMPLIN AVE, P.O.B., SUITE 335
UTICA, NY 13502
Pharmacist
1656 CHAMPLIN AVE
UTICA, NY 13502
Nurse Practitioner
1656 CHAMPLIN AVE
UTICA, NY 13502
Speech-Language Pathologist
1656 CHAMPLIN AVE
UTICA, NY 13502
Physician Assistant
1656 CHAMPLIN AVE
UTICA, NY 13502
Dentist
1656 CHAMPLIN AVE
UTICA, NY 13502
Social Worker
1656 CHAMPLIN AVE
UTICA, NY 13502
Student in an Organized Health Care Education/Training Program
1656 CHAMPLIN AVE
UTICA, NY 13502

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Pylman's NPI number?

The NPI number for John Pylman is 1053560805. It was assigned to this individual provider in the NPPES registry on September 17, 2008.

Where is John Pylman located?

John Pylman practices at 1656 Champlin Ave, Utica, NY 13502. The listed phone number is (315) 624-6467.

What is John Pylman's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is John Pylman enrolled in Medicare?

Yes. John Pylman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is John Pylman affiliated with any hospitals?

According to CMS data, John Pylman is affiliated with Wynn Hospital.

When was this NPI record last updated?

The NPPES record for John Pylman was last updated on April 22, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.