Douglas Charles Fullerton

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN9467663 Issued in FL

Practice address

1400 NW 12TH Ave
Miami, FL 33136-1003

Phone

(347) 875-0165

NPI assigned

Jun 16, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Univ of Miami Hospital and Clinics-Sylvester Compr Hospital, Miami, FL, CCN 100079

Merit-based Incentive Payment System (MIPS)

Final score

87.93 of 100Reported as group

Quality

78.79

Promoting interoperability

100

Improvement activities

40

Cost

71.44

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: dfullerton62049@direct.med.miami.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.

• University of Miami

  dba UMiami Medicine - Hepatology

  • Hepatology Physician
  • Miami, FL
  • NPI 1013967827
  Medicare reassignment Care Compare group NPD
• Weill Medical College of Cornell

  dba Nyph / WCMC Crna's

  • Certified Registered Nurse Anesthetist
  • New York, NY
  • NPI 1164768305

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• University of Miami

  dba UMiami Medicine Multi Specialty Services

  • Internal Medicine Physician
  • Miami Beach, FL
  • NPI 1124768627
  NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD

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

• University of Miami Hospital and Clinics

  dba Sylvester Comprehensive Cancer Center

  • Special Hospital
  • Miami, FL
  • NPI 1679660617
  Care Compare affiliation

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1174937304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9440 BYRON AVE",
            "city": "SURFSIDE",
            "state": "FL",
            "postal_code": "331542440",
            "telephone_number": "347-875-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "347-875-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "DOUGLAS",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "608702",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "608702",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9467663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Precision Health PLLC
• Full Spectrum Integrated Educational Support Services, LLC (Full Spectrum)
• Karla Caridad Fuller, COTA/L
• Lisa Beth Fuller, PSY.D.
• Lynnette Yvette Fuller, LMHC
• Natalia Fullerton, MD
• Traniece Yvette Fullwood
• Dianeska Fumero Garcia
• Ana O Fumero Gonzalez
• Emelin Fumero Izquierdo

• Certified Registered Nurse Anesthetist in Miami, FL
• Providers in Miami, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.