Samuel Edward Fuller, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

43466 Issued in CO

Practice address

1801 16TH St
Greeley, CO 80631-5154

Phone

(303) 761-9190

Fax

(720) 874-4462

NPI assigned

Jul 13, 2006

Last updated

Dec 9, 2022By 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 6

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in NE, CO, KS3 enrollments

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 3

Specialty

Diagnostic Radiology

Education

Saint Louis University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Imaging of Colorado Radiology Imaging Assc PC Etal PTGroup PAC ID 5395644702, 122 clinicians

Hawaii Radiologic Associates LTDGroup PAC ID 0941190953, 91 clinicians

Radiology Imaging Associates PCGroup PAC ID 2860391257, 147 clinicians

National Jewish HealthGroup PAC ID 4587577028, 244 clinicians

Orthopedic Centers of Colorado LLCGroup PAC ID 2365714540, 327 clinicians

Banner Imaging Services Colorado LLCGroup PAC ID 7416377270, 90 clinicians

Gunnison Valley HospitalGroup PAC ID 8426040486, 81 clinicians

Uchealth Imaging Services LLCGroup PAC ID 5799021291, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001
• Sterling Regional Medcenter Hospital, Sterling, CO, CCN 060076
• Banner Fort Collins Medical Center Hospital, Fort Collins, CO, CCN 060126
• AdventHealth Porter Hospital, Denver, CO, CCN 060064
• AdventHealth Littleton Hospital, Littleton, CO, CCN 060113

Merit-based Incentive Payment System (MIPS)

Final score

43.24 of 100Reported as group

Quality

73.53

Promoting interoperability

0

Improvement activities

0

Cost

70.6

Merit-based Incentive Payment System (MIPS)

Final score

84.14 of 100Reported as group

Quality

83.98

Improvement activities

40

Cost

76.51

Merit-based Incentive Payment System (MIPS)

Final score

81.78 of 100Reported as group

Quality

69.37

Promoting interoperability

100

Improvement activities

40

Cost

65.17

Merit-based Incentive Payment System (MIPS)

Final score

70.7 of 100Reported as group

Quality

65.53

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

67.5 of 100Reported as group

Quality

58.12

Improvement activities

40

Cost

68.45

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 32)

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.

• Banner Imaging Services Colorado LLC

  • Diagnostic Radiology Physician
  • Loveland, CO
  • NPI 1326674979
  Medicare reassignment Care Compare group NPD
• Gunnison Valley Hospital

  • Critical Access Hospital
  • Gunnison, CO
  • NPI 1932109048

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Medical Imaging of Colorado Radiology Imaging Assc PC Etal PT

  • Diagnostic Radiology Physician
  • Englewood, CO
  • NPI 1336188234
  Medicare reassignment Care Compare group NPD
• National Jewish Health

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1326015777
  Medicare reassignment Care Compare group NPD
• Orthopedic Centers of Colorado, LLC

  dba Perioperative Medicine Care Center

  • Orthopaedic Surgery Physician
  • Denver, CO
  • NPI 1801339502
  Medicare reassignment Care Compare group NPD
• Radiology Imaging Associates, PC

  • Diagnostic Radiology Physician
  • Englewood, CO
  • NPI 1679513196

  KS, NE

  Medicare reassignment Care Compare group NPD
• Hawaii Radiologic Associates, LTD.

  • Diagnostic Radiology Physician
  • Hilo, HI
  • NPI 1174679443

  CO

  Medicare reassignment Care Compare group NPD
• Uchealth Imaging Services, LLC

  • Diagnostic Radiology Physician
  • Broomfield, CO
  • NPI 1396210902
  Medicare reassignment Care Compare group
• Radiology Imaging of Nebraska, LLC

  • Diagnostic Radiology Physician
  • Scottsbluff, NE
  • NPI 1184869901

  CO

  Medicare reassignment
• Gunnison Valley Hospital

  dba Gunnison Valley Urgent Care Center

  • Urgent Care Clinic/Center
  • Gunnison, CO
  • NPI 1477361228

  Diagnostic Radiology

  NPD
• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Superior, CO
  • NPI 1336870856
  NPD
• Uchealth Imaging Services, LLC

  • Diagnostic Radiology Physician
  • Highlands Ranch, CO
  • NPI 1043162142
  NPD

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

• Banner Health

  dba Banner Fort Collins Medical Center

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1659787554
  Care Compare affiliation
• North Colorado Medical Center

  • General Acute Care Hospital
  • Loveland, CO
  • NPI 1174231682
  Care Compare affiliation
• North Colorado Medical Center

  • Critical Access Hospital
  • Greeley, CO
  • NPI 1255971404
  Care Compare affiliation
• North Colorado Medical Center

  • Ambulance
  • Greeley, CO
  • NPI 1457850430

  Hospital

  Care Compare affiliation
• North Colorado Medical Center

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1477376986
  Care Compare affiliation
• North Colorado Medical Center

  • Special Hospital
  • Loveland, CO
  • NPI 1487535431
  Care Compare affiliation
• North Colorado Medical Center

  • Critical Access Hospital
  • Greeley, CO
  • NPI 1578103750
  Care Compare affiliation
• North Colorado Medical Center

  • Emergency Care Clinic/Center
  • Greeley, CO
  • NPI 1588928519

  Hospital

  Care Compare affiliation
• North Colorado Medical Center

  • Infusion Therapy Clinic/Center
  • Loveland, CO
  • NPI 1700668183

  Hospital

  Care Compare affiliation
• North Colorado Medical Center

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1720004450
  Care Compare affiliation
• North Colorado Medical Center

  • Critical Access Hospital
  • Greeley, CO
  • NPI 1831739267
  Care Compare affiliation
• North Colorado Medical Center

  • Ambulance
  • Greeley, CO
  • NPI 1861989212

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1093730749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 E GEDDES AVE STE 300",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801123895",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315154",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 E Geddes Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801123895",
            "country_code": "US",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SAMUEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A72891",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WY",
            "license": "7318A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "23277",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-41647",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "HI",
            "license": "MD19873",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "43466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "KA3249113",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "111257122",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "650671",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88153746",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NA1214128",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "638284YQ33",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "638284YQN9",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "638284YQPG",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NA1215129",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "638284AE6Y",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NA2517106",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "638284ZLJ3",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lanae Fuentes
• James Kelii Fujimoto Jr.
• Sarah Lois Fulkerson, BA
• Alexander Fuller, ARNP
• Marsha Lee Fuller, PMHNP
• Sandra Fuller, PEER
• Functional Lifestyle Systems Inc
• Fundamental Chromatic Nonprofit Organization Inc
• David C Funderburk, DDS
• Brennen Anthony Furgeson

• Diagnostic Radiology Physician in Greeley, CO
• Providers in Greeley, CO by specialty
• Diagnostic Radiology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.