NPIMap

Individual provider Active NPI

Timothy Fullerton

  • Family Medicine Physician
  • Mercer, PA
National Provider Identifier
1295964195
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS016025 Issued in PA
Practice address
737 Greenville Rd
Mercer, PA 16137-5070
Phone
(724) 662-2650
Fax
(724) 662-1338
NPI assigned
Jul 13, 2009
Last updated
May 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS016025 PA Primary

Addresses

Primary practice location

737 Greenville Rd
Mercer, PA 16137-5070

Mailing address

100 Shenango Ave
P.O. Box 716
Sharon, PA 16146-1503
Phone (724) 662-2650

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothy.m.fullerton@upmcdirect.com UPMC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120918000020 PA Practitioner - Family Practice 1355599366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health NetworkGroup PAC ID 9234046228, 64 clinicians

Practice addresses (Care Compare)

737 Greenville Rd
Mercer, PA 16137-5070
Phone (724) 662-2650

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Primary Health Network CurrentSince Sep 1, 2012 Accepting new patients
Upmc Community Medicine, Inc Current Accepting new patients
Primary Health Network CurrentSince Sep 1, 2012 Accepting new patients
Upmc Community Medicine Inc Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Primary Health Network Family Medicine Past Accepting new patients

Locations

2000 Green St
Farrell, PA 16121
Phone (724) 342-6600

2000 Memorial Dr
Farrell, PA 16121
Phone (724) 528-2513

348 Main St
Greenville, PA 16125
Phone (724) 588-5250

737 Greenville Rd
Mercer, PA 16137
Phone (724) 662-2650

2 Hot Metal St
Fl 3
Pittsburgh, PA 15203
Phone (412) 432-5869

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

100 Shenango Ave
Sharon, PA 16146
Phone (724) 704-8886

63 Pitt St
Sharon, PA 16146
Phone (724) 342-6604

Interoperability endpoints

  • Direct secure messaging: timothyfullerton@primaryhn.medalliesdirect.net

Organizations & group practices 6

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.

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": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1295964195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "address_2": "P.O. BOX 716",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161461503",
            "telephone_number": "724-662-2650",
            "fax_number": "724-662-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 GREENVILLE RD",
            "city": "MERCER",
            "state": "PA",
            "postal_code": "161375070",
            "telephone_number": "724-662-2650",
            "fax_number": "724-662-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS016025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.m.fullerton@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mercer, PA

Sources for this page

Verify at the official NPI Registry.