NPIMap

Individual provider Active NPI

Spencer Fuller, MD, MPH

  • Retina Specialist (Ophthalmology) Physician
  • Reno, NV
National Provider Identifier
1124513023
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
24889 Issued in NV
Practice address
5449 Reno Corporate Dr Ste 200
Reno, NV 89511-2626
Phone
(775) 737-9411
Fax
(775) 737-9413
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2018020280 MO
Ophthalmology Physician 207W00000X 12685949-1205 UT
Retina Specialist (Ophthalmology) Physician 207WX0107X 24889 NV Primary
Internal Medicine Physician 207R00000X 2018020280 MO

Addresses

Primary practice location

5449 Reno Corporate Dr Ste 200
Reno, NV 89511-2626

Mailing address

5449 Reno Corporate Dr Ste 200
Reno, NV 89511-2626
Phone (775) 737-9411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220603000552 UT Practitioner - Ophthalmology 4688052681 Reassigns benefits to 1 organization
I20240515001396 NV Practitioner - Ophthalmology 4688052681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, San Diego School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H Dhindsa Retina Eye Center, LTDGroup PAC ID 5294906137, 3 clinicians

Practice addresses (Care Compare)

5449 Reno Corporate Dr
Suite 200
Reno, NV 89511-2626
Phone (775) 737-9411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018020280MOMDOphthalmology Physician
12685949-1205UTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince May 1, 2022 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince May 1, 2022 Accepting new patients
H. Dhindsa Retina Eye Center, LTD. Ophthalmology CurrentSince Jul 1, 2024 Accepting new patients

Locations

5449 Reno Corporate Dr
Ste 200
Reno, NV 89511
Phone (775) 737-9411

65 S Mario Capecchi Dr
Salt Lake City, UT 84132
Phone (801) 581-2352

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: sfuller@hdretina.intellechartdirect.net

Organizations & group practices 4

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 9

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1124513023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5449 RENO CORPORATE DR STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112626",
            "telephone_number": "775-737-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5449 RENO CORPORATE DR STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112626",
            "telephone_number": "775-737-9411",
            "fax_number": "775-737-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SPENCER",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2018020280",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "12685949-1205",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NV",
            "license": "24889",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018020280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.