Individual provider Active NPI

Tiffany C Fulton, MD

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1295356780
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
330 Brookline Ave # Shapiro8
Boston, MA 02215-5491
Phone
(617) 667-3736
Fax
(617) 667-7493
NPI assigned
May 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MA Primary

Addresses

Primary practice location

330 Brookline Ave # Shapiro8
Boston, MA 02215-5491

Mailing address

330 Brookline Ave # Eks3
Boston, MA 02215-5491
Phone (617) 667-2285

Other names 1

  • Dr. Tiffany C Minors Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807002794 MA Practitioner - Obstetrics/Gynecology 0244777258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Harvard Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brigham Faulkner OB GYN Associates PCGroup PAC ID 7214924786, 6 clinicians

Practice addresses (Care Compare)

1153 Centre St
Boston, MA 02130-3446
Phone (617) 983-7003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1018773MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women's Faulkner Hospital, Inc Current Accepting new patients
Brigham Faulkner OB GYN Associates PC CurrentSince Jul 1, 2024 Accepting new patients
Brigham & Womens Hospital, Inc. Past Accepting new patients

Locations

1153 Centre St
Ste 36
Jamaica Plain, MA 02130
Phone (617) 983-7003

1153 Centre St
Ste 3C
Jamaica Plain, MA 02130
Phone (617) 983-7003

Interoperability endpoints

  • Direct secure messaging: fulton.tiffany.fh@direct.partners.masshiway.net

Organizations & group practices 3

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 3

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1295356780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE # EKS3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-2285",
            "fax_number": "617-667-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE # SHAPIRO8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-3736",
            "fax_number": "617-667-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "TIFFANY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "MINORS",
            "middle_name": "C",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.