Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. GAUTAM JHA MD
NPI 1447314737
Internal Medicine in Effingham, IL

Q: What is Gautam Jha's NPI number?

The NPI number for Gautam Jha is 1447314737. It was assigned to this individual provider in the NPPES registry on December 20, 2006.

Q: What is Gautam Jha's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Gautam Jha was last updated on October 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 20, 2006PECOS Enrolled

96.98/100

CMS Quality Rating

1901 S 4TH ST STE 30, EFFINGHAM, IL 62401(877) 275-3754(877) 933-2954 Get Directions Write a Review

NPPES record last updated: October 21, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 9, 2026, Oct 11, 2024, May 13, 2016 (3 updates tracked since 2016).

On this page

About Mr. Gautam Jha Md NPPES

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

MR. GAUTAM JHA MD (NPI 1447314737) is an individual internal medicine provider in Effingham, Illinois, licensed in Illinois (036096423) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital -centralia, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1447314737

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMR. GAUTAM JHACredential: MD

Location Address1901 S 4TH ST STE 30Effingham, IL 62401-4162

Mailing Address1901 S 4th St Ste 30Effingham, IL 62401-4162 · (877) 275-3754 · Fax (877) 933-2954

Phone(877) 275-3754

Fax(877) 933-2954

Sole ProprietorYes

Medical School CMSOtherGraduated 1992

Enumeration DateDecember 20, 2006

Last NPPES UpdateOctober 21, 20263 updates tracked since enumeration

NPPES CertifiedOctober 21, 2026

✔ NPI 1447314737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036096423

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1901 S 4TH ST STE 30, Effingham, IL 62401

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Other Identifiers 1

Medicaid036096423IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Gautam Jha Md 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 ID3173711447

PECOS Enrollment IDI20101230000850

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.

Medicare Billing Reassignments

Medicare enrollment records show Gautam Jha reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Salem Township Hospital

39 mi

Rural Health

1201 RICKER DRIVE
Salem, IL 62881

Reassigned Medicare billing, Illinois enrollment
44 clinicians in this Medicare group

NPI 1265467195 (618) 548-9502

Amky Mso-1 PLLC

40 mi

Family Medicine

1325 W WHITTAKER ST STE D
Salem, IL 62881

Reassigned Medicare billing, Illinois enrollment
5 clinicians in this Medicare group

NPI 1821817503 (678) 982-3590

St. Mary's Hospital, Centralia, Illinois

51 mi

Anesthesiology

400 N PLEASANT AVE
Centralia, IL 62801

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: St Marys Hospital Centralia Illinois
392 clinicians in this Medicare group

NPI 1477097871 (618) 436-6056

Good Samaritan Regional Health Center

59 mi

Emergency Medicine

1 GOOD SAMARITAN WAY
Mount Vernon, IL 62864

Reassigned Medicare billing, Illinois enrollment
284 clinicians in this Medicare group

NPI 1487758801 (618) 899-4600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 18

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

1,427 services329 patients

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

1,020 services11 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

245 services245 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

183 services78 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

165 services110 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

81 services72 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

74 services22 patients

Injection, zoledronic acid, 1 mg J3489

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

70 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

68 services66 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

67 services21 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

64 services45 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

49 services47 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

43 services37 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.

24 services17 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

22 services21 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

16 services16 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

15 services15 patients

Nursing facility discharge day management, 30 minutes or less 99315

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

15 services15 patients

Hospital Affiliations CMS Care Compare 5

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

Ssm Health St Mary's Hospital -Centralia

Acute Care Hospitals · Centralia, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140034

Location400 North Pleasant AvenueCentralia, IL 62801 · Marion County

Emergency services

Good Samaritan Regional Hlth Center

Acute Care Hospitals · Mount Vernon, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140046

Location1 Good Samaritan WayMount Vernon, IL 62864 · Jefferson County

Emergency services Birthing friendly

Sarah Bush Lincoln Health Center

Acute Care Hospitals · Mattoon, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140189

Location1000 Health Center Drive P O Box 372Mattoon, IL 61938 · Coles County

Emergency services Birthing friendly

Salem Township Hospital

Critical Access Hospitals · Salem, IL

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number141345

Location1201 Ricker DriveSalem, IL 62881 · Marion County

Emergency services

Clay County Hospital

Critical Access Hospitals · Flora, IL

OwnershipGovernment - Local

CMS Certification Number141351

Location911 Stacy Burk DrFlora, IL 62839 · Clay County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62401 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

96.98/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

83.89

Promoting Interoperability

100

Improvement Activities

Cost

Referred Medical Equipment & Supplies CMS DME claims 32

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers60 claims138 services$5.72 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers32 claims38 services$1.05 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

4 suppliers15 claims15 services$43.08 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

2 suppliers11 claims22 services$61.39 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

3 suppliers38 claims76 services$1.67 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

4 suppliers37 claims37 services$106.68 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers34 claims47 services$42.35 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

6 suppliers25 claims25 services$71.51 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

6 suppliers38 claims38 services$25.03 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

6 suppliers31 claims31 services$21.08 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

6 suppliers70 claims182 services$2.69 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

5 suppliers21 claims21 services$14.27 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims348 services$7.64 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims6,014 services$0.38 avg. paid by Medicare

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

2 suppliers13 claims13 services$71.57 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers19 claims19 services$72.61 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers54 claims54 services$18.15 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier12 claims12 services$16.89 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

4 suppliers65 claims66 services$7.80 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers30 claims30 services$55.38 avg. paid by Medicare

Iv pole E0776

DME-Other DME · category DE000N

1 supplier12 claims12 services$13.88 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

5 suppliers139 claims139 services$109.48 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers60 claims62 services$36.93 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

5 suppliers53 claims3,300 services$4.60 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

4 suppliers77 claims4,350 services$6.51 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

8 suppliers40 claims6,941 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

8 suppliers51 claims5,190 services$0.08 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

7 suppliers95 claims5,460 services$0.82 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

5 suppliers97 claims509,250 services$0.15 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier24 claims24 services$23.49 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers154 claims154 services$205.92 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

10 suppliers172 claims172 services$25.16 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Gautam Jha's NPI number?

The NPI number for Gautam Jha is 1447314737. It was assigned to this individual provider in the NPPES registry on December 20, 2006.

Where is Gautam Jha located?

Gautam Jha practices at 1901 S 4th St Ste 30, Effingham, IL 62401. The listed phone number is (877) 275-3754.

What is Gautam Jha's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Gautam Jha enrolled in Medicare?

Yes. Gautam Jha 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.

Which organizations bill Medicare for Gautam Jha's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gautam Jha reassigns Medicare benefits to 4 organizations: Salem Township Hospital (Salem, IL), Amky Mso-1 PLLC (Salem, IL), St. Mary's Hospital, Centralia, Illinois (Centralia, IL) and Good Samaritan Regional Health Center (Mount Vernon, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gautam Jha's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gautam Jha accept?

Health plans from Medica list Gautam Jha as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gautam Jha affiliated with any hospitals?

According to CMS data, Gautam Jha is affiliated with Ssm Health St Mary's Hospital -Centralia, Good Samaritan Regional Hlth Center, Sarah Bush Lincoln Health Center, Salem Township Hospital and Clay County Hospital.

When was this NPI record last updated?

The NPPES record for Gautam Jha was last updated on October 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.