Active NPI
Nikolaus Christian Fulbright, M.D.
- Family Medicine Physician
- Sterling Heights, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301098657
- Practice address
- 44250 Dequindre Rd
Sterling Heights, MI 48314-1002 - Phone
- (248) 964-0430
- NPI assigned
- Jul 1, 2011
- Last updated
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301098657 | MI | Primary |
Addresses
Primary practice location
44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Mailing address
4411 Robinwood Ave
Royal Oak, MI 48073-1532
Phone (810) 300-8788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Wayne State University School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 424-3000
16001 W 9 Mile Rd 3Rd FL
Providence Hospital Gastrology
Southfield, MI 48075-4818
Phone (248) 849-6033
16001 W 9 Mile Rd 3Rd Floor
Providence Hospital Gastrology
Southfield, MI 48075-4818
Phone (248) 849-6033
210 N Lafayette St
South Lyon, MI 48178-2048
22250 Providence Dr
FL 5
Southfield, MI 48075-4825
Phone (248) 849-3441
Hospital & facility affiliations
- Ascension Providence Hospital, Southfield and Novi
- Henry Ford Health St John Hospital
- Henry Ford Health Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301098657 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Providence Hospital | Current | Accepting new patients | |
| Henry Ford Health Providence Hospital | Family Medicine | Current | Accepting new patients |
| Henry Ford Health Providence Hospital | Current | Accepting new patients | |
| Henry Ford Health Providence Hospital | Past | Accepting new patients |
Locations
210 N Lafayette St
South Lyon, MI 48178
Phone (248) 437-1744
22250 Providence Dr
Fl 5
Southfield, MI 48075
Phone (248) 849-3441
28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944
Interoperability endpoints
- nfulbright1127352@direct.hfhs.org
- nikolaus.fulbright.1@16555.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Henry Ford Providence Hospital
- Surgery Physician
- Southfield, MI
- NPI 1942265236
-
dba Henry Ford Providence Hospital
- Pediatrics Physician
- Southfield, MI
- NPI 1265497226
-
dba Henry Ford Providence Hospital
- Family Medicine Physician
- Southfield, MI
- NPI 1538123963
-
- General Acute Care Hospital
- Novi, MI
- NPI 1144210253
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Novi, MI
- NPI 1144210253
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
dba St John Hospital and Medical Center
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1235426966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4411 ROBINWOOD AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480731532",
"telephone_number": "810-300-8788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44250 DEQUINDRE RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483141002",
"telephone_number": "248-964-0430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULBRIGHT",
"first_name": "NIKOLAUS",
"middle_name": "CHRISTIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-01",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301098657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.