JAISE THEKKAN POULOSE M.D.
NPI 1497872675
Internal Medicine - Critical Care Medicine in Edgewood, KY

Q: What is Jaise Poulose's NPI number?

The NPI number for Jaise Poulose is 1497872675. It was assigned to this individual provider in the NPPES registry on March 23, 2007.

Q: What is Jaise Poulose's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Jaise Poulose was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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 March 23, 2007PECOS EnrolledAccepts Medicare Assignment

1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017(859) 757-2927(859) 341-0203 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 6, 2025, Jul 9, 2025, Mar 24, 2021 and 2 more (5 updates tracked since 2016).

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About Jaise Thekkan Poulose M.d. NPPES

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

JAISE THEKKAN POULOSE M.D. (NPI 1497872675) is an individual critical care medicine provider in Edgewood, Kentucky, licensed in Kentucky (53941) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Edgewood, and maintains a secondary practice location in Hopkinsville.

NPPES Registry Identity

NPI1497872675

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameJAISE THEKKAN POULOSECredential: M.D.

Location Address1 MEDICAL VILLAGE DREdgewood, KY 41017-3403

Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 757-2927 · Fax (859) 341-0203

Phone(859) 757-2927

Fax(859) 341-0203

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateMarch 23, 2007

Last NPPES UpdateAugust 6, 20255 updates tracked since enumeration

NPPES CertifiedAugust 6, 2025

✔ NPI 1497872675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

Licenses✔ Licensed in KY · 53941✔ Licensed in MN · 50104

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 11150 (ND)

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License MD.207663 (LA)

1 MEDICAL VILLAGE DR, Edgewood, KY 41017

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Secondary Practice Location 1

Location 1320 W 18th StHopkinsville, KY 42240-1965 · Phone (270) 887-0100

Other Identifiers 7

Medicaid913427000MN

Medicaid10502ND

MedicaidENROLLEDMN

MedicaidN714361ND

Medicaid7100672860KY

Medicaid35190900WI

MedicaidENROLLEDIA

Accepted Insurance

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

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

Jaise Thekkan Poulose 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 ID6002916723

PECOS Enrollment IDI20200710002790

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 6

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

155 services45 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.

111 services40 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

57 services41 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

35 services35 patients

Insertion of artery tube for blood sampling or infusion through skin 36620

This procedure involves placing a small tube into an artery, usually in the wrist or elbow, to collect blood samples or administer medication. It's done under local anesthesia and is a common, safe practice.

21 services18 patients

Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556

This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.

13 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number180035

Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County

Emergency services Birthing friendly

St Elizabeth Florence

Acute Care Hospitals · Florence, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180045

Location4900 Houston RoadFlorence, KY 41042 · Boone County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41017 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

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.

CARA LINDSAY HANSEN CRNA

Nurse Anesthetist, Certified Registered