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

Jaise Thekkan Poulose, MD

Individual provider Cardiovascular Disease Physician · NPI 1497872675

Jaise Thekkan Poulose, MD is a Critical Care (Intensivists) in Edgewood, Kentucky. Qualified in 2001, 25 years ago. Practices with Summit Medical Group Inc, a 799-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kentucky, Louisiana, Minnesota and North Dakota.

Years since qualifying
25
Licensed in
KY, LA, MN, ND
In the registry since
2007
Specialties on file
4
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

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone: (859) 757-2927
Fax: (859) 341-0203
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 320 W 18th St, Hopkinsville, KY 42240-1965 — (270) 887-0100

Specialties & licences

Critical Care Medicine (Internal Medicine) Physician (primary) Taxonomy 207RC0200X · Licence 53941 (KY)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 11150 (ND)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence 50104 (MN)
Pulmonary Disease Physician Taxonomy 207RP1001X · Licence MD.207663 (LA)

Record details

NPI number1497872675
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2007
Last updated in NPPESAugust 6, 2025
Certification dateAugust 6, 2025

Medicare enrollment

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

Medicare specialtyCRITICAL CARE (INTENSIVISTS)
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Summit Medical Group Inc — 799 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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