Teresa Fuller, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0058861 Issued in MD

Practice address

10084 Reisterstown Rd Ste 200B
Owings Mills, MD 21117-4096

Phone

(410) 526-7993

Fax

(410) 526-5144

NPI assigned

Mar 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: teresafuller@msp.allscriptsdirect.net
• Direct secure messaging: tfuller356173@direct.umm.edu

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

• Lifebridge Community Pediatrics, LLC

  • Pediatrics Physician
  • Towson, MD
  • NPI 1629495528
  Medicare reassignment NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1073582193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E UNIVERSITY PKWY UNIT 109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182432",
            "telephone_number": "410-235-1601",
            "fax_number": "410-467-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10084 REISTERSTOWN RD STE 200B",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174096",
            "telephone_number": "410-526-7993",
            "fax_number": "410-526-5144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E University Pkwy Unit 109",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212182432",
            "country_code": "US",
            "telephone_number": "410-235-1601",
            "fax_number": "410-467-6881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "TERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0058861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400185100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whei-Rung Fu, M.D.
• Bracha Fudem
• Luis Miguel Fuerte
• Robert Fuld, M.D.
• Linda K Fuller, M.A., CCC-A
• Devorah Furman
• Blessing Gabriel
• Malav Gadani
• Erica Gaertner, M.D.
• Jessie Pearl Gaither

• Pediatrics Physician in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.