Active NPI
Stephanie Fuller, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- D0105511
- Practice address
- 34TH & Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4399 - Phone
- (215) 590-2708
- Fax
- (215) 590-2715
- NPI assigned
- Jul 3, 2007
- Last updated
- Dec 9, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD420734 | PA | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | D0105511 | MD | Primary |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD420734 | PA |
Addresses
Primary practice location
34TH & Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4399
Mailing address
6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 955-5000
Other practice location 1
1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-5000 ext. 32704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100743887-0030 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NJ, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Surgery
- Education
- Eastern Virginia Medical School, 1999
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-5000
600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000
600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD420734 | PA | MD | Surgery Physician |
| D0105511 | MD | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Surgical Associates LTD | Current | Accepting new patients | |
| Johns Hopkins University | Current | Accepting new patients | |
| Children's Surgical Associates of New Jersey Inc | Current | Accepting new patients | |
| Johns Hopkins University | Surgery | Current | Accepting new patients |
| Children's Surgical Associates of New Jersey Inc | Current | Accepting new patients | |
| Children's Surgical Associates of New Jersey Inc | Surgery | Current | Accepting new patients |
Locations
1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037
600 N Wolfe St
Baltimore, MD 21287
6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704
4009 Black Horse Pike
Mays Landing, NJ 08330
Phone (267) 425-9505
101 Plainsboro Rd
Plainsboro, NJ 08536
Phone (267) 425-9505
1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086
200 Bowman Dr
Fl 2
Voorhees, NJ 08043
Phone (267) 425-5400
100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538
100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040
Organizations & group practices 7
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.
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Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1578597993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1013115930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6201 GREENLEIGH AVE",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212202004",
"telephone_number": "410-955-5000",
"fax_number": "410-500-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34TH & CIVIC CENTER BLVD",
"address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044399",
"telephone_number": "215-590-2708",
"fax_number": "215-590-2715"
}
],
"practiceLocations": [
{
"address_1": "1800 Orleans St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212870010",
"country_code": "US",
"telephone_number": "410-955-5000 x32704",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FULLER",
"first_name": "STEPHANIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-03",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD420734",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MD",
"license": "D0105511",
"primary": true
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "PA",
"license": "MD420734",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100743887-0030",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.