NPIMap

Individual provider Active NPI

Bradley Fuller, MD

  • Internal Medicine Physician
  • Billings, MT
National Provider Identifier
1083652564
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10392 Issued in MT
Practice address
2900 12TH Ave N
Suite 310W
Billings, MT 59101-7506
Phone
(406) 238-6900
Fax
(406) 238-6939
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10392 MT Primary

Addresses

Primary practice location

2900 12TH Ave N
Suite 310W
Billings, MT 59101-7506

Mailing address

4045 Avenue B
Suite 310W
Billings, MT 59106-1738
Phone (406) 651-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050428001097 MT Practitioner - Internal Medicine 1850330861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fuller Family Medicine, PCGroup PAC ID 1557533312, 3 clinicians

Practice addresses (Care Compare)

4045 Ave B
Billings, MT 59106-1738
Phone (406) 690-4997

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10392MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fuller Family Medicine, PC Internal Medicine CurrentSince Sep 12, 2011 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

4045 Avenue B
Billings, MT 59106
Phone (406) 690-4997

4045 Avenue B
Ste 310W
Billings, MT 59106

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAEEBA/Endpoint/AAEEBA

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1083652564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 AVENUE B",
            "address_2": "SUITE 310W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591061738",
            "telephone_number": "406-651-9355",
            "fax_number": "406-651-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 310W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-238-6900",
            "fax_number": "406-238-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "10392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.