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JAYAKUMAR THOTAMBILU, PHYSICIAN, P.C.
NPI 1457629453
Specialist in Fulton, NY

Active since December 05, 2011
522 S 4TH ST, SUITE 1300, FULTON, NY 13069(315) 592-4000(315) 593-3222 Get Directions Write a Review

NPPES record last updated: December 5, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jayakumar Thotambilu, Physician, P.c. NPPES

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

JAYAKUMAR THOTAMBILU, PHYSICIAN, P.C. (NPI 1457629453) is a healthcare organization registered as a specialist in Fulton, New York and active in the NPI registry since December 2011. The organization lists Jayakumar Thotambilu, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1457629453
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameJAYAKUMAR THOTAMBILU, PHYSICIAN, P.C.
Location Address522 S 4TH ST, SUITE 1300Fulton, NY 13069-2946
Mailing Address522 S 4th St, Suite 1300Fulton, NY 13069-2946 · (315) 592-4001 · Fax (315) 593-3222
Phone(315) 592-4000
Fax(315) 593-3222
Organization SubpartNo
Authorized OfficialJayakumar ThotambiluOwner/physician · (315) 592-4000
Enumeration DateDecember 5, 2011
✔ NPI 1457629453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 001219
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
522 S 4TH ST, Fulton, NY 13069
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Other Identifiers 2

Medicare UPING51168NY
Medicaid01805352NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

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

SAMANTHA GOUTERMOUT NP
Nurse Practitioner
522 S 4TH ST
FULTON, NY 13069
Oswego County (315) 592-3930
MARIE E. CASTILLO-ALCASID M.D.
Internal Medicine
522 S 4TH ST, SUITE 500
FULTON, NY 13069
Oswego County (315) 598-4740
KIMBERLY ANNE POWERS LMHC
Counselor (Mental Health)
522 S 4TH ST
FULTON, NY 13069
Oswego County (315) 598-7400
MARIE-JEANNE DESRAVINES M.D.
Family Medicine
522 S 4TH ST, SUITE 500
FULTON, NY 13069
Oswego County (315) 598-4740
KYLIE M. LACEY N.P.
Nurse Practitioner (Family)
522 S 4TH ST, SUITE 500
FULTON, NY 13069
Oswego County (315) 598-4740
M ZAEEM ANSARI, M.D., P.C.
Internal Medicine (Cardiovascular Disease)
522 S 4TH ST, SUITE 1500
FULTON, NY 13069
Oswego County (315) 593-2010
SUSAN A. KRZYZAK N.P.
Nurse Practitioner (Family)
522 S 4TH ST, SUITE 500
FULTON, NY 13069
Oswego County (315) 598-4740
DR. ANDREW ROGALL M.D.
Family Medicine
522 S 4TH ST
FULTON, NY 13069
Oswego County (315) 592-3930

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 Jayakumar Thotambilu, Physician, P.C.'s NPI number?

The NPI number for Jayakumar Thotambilu, Physician, P.C. is 1457629453. It was assigned to this organization in the NPPES registry on December 5, 2011.

Where is Jayakumar Thotambilu, Physician, P.C. located?

Jayakumar Thotambilu, Physician, P.C. is located at 522 S 4th St Suite 1300, Fulton, NY 13069. The listed phone number is (315) 592-4000.

What is Jayakumar Thotambilu, Physician, P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Jayakumar Thotambilu, Physician, P.C. was last updated on December 5, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.