Connor M Fultz, MD

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

MD486957 Issued in PA

Practice address

2400 Maryland Rd Ste 20
Willow Grove, PA 19090-1732

Phone

(800) 321-9999

Fax

(267) 479-1321

NPI assigned

Apr 9, 2020

Last updated

Sep 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports MedicineAlso: Physical Medicine and Rehabilitation

Education

Drexel University College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Reconstructive Orthopaedic Associates II LLCGroup PAC ID 7416845318, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142
• Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
• devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
• OH PPO

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reconstructive Orthopaedic Associates II LLC

  dba Rothman Orthopaedics Institute

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1861433278
  Medicare reassignment Care Compare group NPD
• University of Pittsburgh Physicians

  • Gastroenterology Physician
  • Pittsburgh, PA
  • NPI 1619935004
  Medicare reassignment NPD
• Reconstructive Orthopaedic Associates II LLC

  dba Rothman Orthopaedics Institute

  • Prosthetic/Orthotic Supplier
  • Philadelphia, PA
  • NPI 1497571830
  NPD
• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD
• University of Pittsburgh Physicians

  • Physical Medicine & Rehabilitation Physician
  • Pittsburgh, PA
  • NPI 1770541963

  Sports Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Einstein Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1366653818
  Care Compare affiliation Name & address match
• Philadelphia Post Acute Partners, LLC

  dba Penn Medicine Good Shepherd Rehabilitation

  • Long Term Care Hospital
  • Philadelphia, PA
  • NPI 1427232818

  Long-term care hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1003435132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 520",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074430",
            "telephone_number": "609-677-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MARYLAND RD STE 20",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901732",
            "telephone_number": "800-321-9999",
            "fax_number": "267-479-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTZ",
        "first_name": "CONNOR",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "MD486957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Berman Frankel, MD
• Martin Frederic Freedman, MD
• Lawrence K Freitas, M.D.
• Martha From, CRNP
• Brenda Fuh, PHARMD
• James Richard Fynes, LAT,ATC
• Sundee L Gable
• Deepa Sree Gadde
• Christine Elizabeth Gale, PSY.D.
• Anne Keeler Galgon, PT, PHD, NCS,

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.