Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jerry Varghese Thuthikattu John, MD

Individual provider Family Medicine Physician · NPI 1053920504

Dr. Jerry Varghese Thuthikattu John, MD is a Family Practice in Jamestown, New York. Qualified in 2019, 7 years ago. Practices with Great Lakes Physician Practice PC, a 143-clinician group and accepts Medicare assignment. Licensed in New York and Wisconsin.

Years since qualifying
7
Licensed in
NY, WI
In the registry since
2020
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

15 S Main St Ste 150
Jamestown, NY 14701-6627
Phone: (716) 483-6700
Fax: (716) 664-7275
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 325117 (NY)
Family Medicine Physician Taxonomy 207Q00000X · Licence 77253-20 (WI)

Record details

NPI number1053920504
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 29, 2020
Last updated in NPPESAugust 3, 2023
Certification dateAugust 3, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Great Lakes Physician Practice Pc — 143 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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