Individual provider Active NPI

Marlin J Fugate, M.D.

  • Diagnostic Radiology Physician
  • Topeka, KS
National Provider Identifier
1275569535
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
04-30249 Issued in KS
Practice address
1303 SW First American PL
Topeka, KS 66604-4059
Phone
(785) 234-2306
Fax
(785) 234-2550
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 04-30249 KS Primary
Diagnostic Radiology Physician 2085R0202X 22513 NE

Addresses

Primary practice location

1303 SW First American PL
Topeka, KS 66604-4059

Mailing address

1303 SW First American PL
Topeka, KS 66604-4059
Phone (785) 234-2306

Other identifiers 2

IdentifierTypeStateIssuer
100458780BMedicaidKS
102945OtherKSBC/BS PREMIER BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-30249KSMDDiagnostic Radiology Physician
22513NEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnetic Resonance Imaging Center of Kansas LP Diagnostic Radiology Past Accepting new patients
Stormont-Vail Pharmacy, LLC PastSince Jan 3, 2011 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mfugate198588@ahs.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1275569535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 SW FIRST AMERICAN PL",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666044059",
            "telephone_number": "785-234-2306",
            "fax_number": "785-234-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 SW FIRST AMERICAN PL",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666044059",
            "telephone_number": "785-234-2306",
            "fax_number": "785-234-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "MARLIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-30249",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "22513",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100458780B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PREMIER BLUE",
            "identifier": "102945",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.