Individual provider Active NPI

Kathleen Fulton, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1194159277
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1113389 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(410) 601-9000
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1113389 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone (410) 601-9000

Other names 1

  • Kathleen Baker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140224001629 MD Practitioner - Physician Assistant 4789814559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216

5051 Greenspring Ave
Baltimore, MD 21209-4354
Phone (410) 601-9513

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1113389MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc CurrentSince Oct 10, 2013 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Oct 10, 2013 Accepting new patients

Locations

2401 W Belvedere Ave
Ofc
Baltimore, MD 21215
Phone (410) 601-1544

5051 Greenspring Ave
Baltimore, MD 21209
Phone (410) 601-1441

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

2435 W Belvedere Ave
Ste 4
Baltimore, MD 21215
Phone (410) 601-5547

2401 W Belvedere Ave
Baltimore, MD 21215

5415 Old Court Rd
Ste S04
Randallstown, MD 21133
Phone (410) 701-4437

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 2

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1194159277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "1113389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "BAKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.