Jeremy Fulk

Primary specialty

OptometristTaxonomy code 152W00000X

License

112293 Issued in AK

Practice address

116 Minnie St
Fairbanks, AK 99701-3006

Phone

(907) 456-7760

NPI assigned

Jul 8, 2016

Last updated

Jan 19, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Arizona College of Osteopathic Medicine Mid Western University, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yukon Eyecare Professionals LLCGroup PAC ID 6406249721, 2 clinicians

Juneau Eyecare Professionals LLCGroup PAC ID 7315432184, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Juneau Eyecare Professionals LLC

  • Optometrist
  • Juneau, AK
  • NPI 1659244978
  Medicare reassignment Care Compare group NPD Authorized official
• Yukon Eyecare Professionals LLC

  • Optometrist
  • Fairbanks, AK
  • NPI 1811649064
  Medicare reassignment Care Compare group NPD Authorized official
• Alaska Eyecare Professionals LLC

  • Optometrist
  • Anchorage, AK
  • NPI 1902748817
  NPD Authorized official

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1134571698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MINNIE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013006",
            "telephone_number": "907-456-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MINNIE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013006",
            "telephone_number": "907-456-7760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 Sadler Way Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997013175",
            "country_code": "US",
            "telephone_number": "907-888-8174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULK",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "112293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Frykman, RN
• Jennifer Frymark
• Kaitlyn Fugate, BCBA
• Carson Fugett
• Tracey Ann Fugett, LCSW
• Stanley R Fuller, M.D.
• Sean Patrick Fullmer, PT, DPT
• Beth Furrow I, MEDICAL ASSISTANT
• James Scott Fuzzard, M.D.
• Derek Fyten

• Optometrist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.