Fulton Porter III, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036101229 Issued in IL

Practice address

17850 Kedzie Ave
3200
Hazel Crest, IL 60429-2058

Phone

(708) 798-8112

Fax

(708) 798-9016

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 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.

• Galen Inpatient Physicians, PC

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1871178368

  IN, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Community Care Network Inc

  • Family Medicine Physician
  • St John, IN
  • NPI 1457610487

  IN, Internal Medicine

  Medicare reassignment NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  IL, Internal Medicine

  Medicare reassignment NPD
• Galen Inpatient Physicians PC

  • Internal Medicine Physician
  • Roseburg, OR
  • NPI 1063833960
  Care Compare group
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1205614336
  Care Compare group
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Germantown, MD
  • NPI 1225923154
  Care Compare group
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Everett, WA
  • NPI 1255261715
  Care Compare group
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Waterbury, CT
  • NPI 1285439703
  Care Compare group
• Galen Inpatient Physicians PC

  • Internal Medicine Physician
  • Wilmington, DE
  • NPI 1285450486
  Care Compare group
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Philadelphia, PA
  • NPI 1639056989
  Care Compare group
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Greenville, SC
  • NPI 1699514620
  Care Compare group
• Galen Inpatient Physicians PC.

  • Hospitalist Physician
  • Fenton, MO
  • NPI 1538714688
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210

  Hospital

  Care Compare affiliation

Specialty

Hospitalist

Education

Northwestern University Feinberg Medical School, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Galen Inpatient Physicians PC 1,045 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1316944341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 KEDZIE AVE",
            "address_2": "3200",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292058",
            "telephone_number": "708-798-8112",
            "fax_number": "708-798-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "FULTON",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01071861A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036101229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101229",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00439469/CK6882",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physicians Community Medical Center Hazel Crest,S.C.
• Rachel E Piepenbrink, CSFA
• Constance Agnes Pietrzak, M.D.
• Pine Crest Health Care LLC
• Pinhas Sharon, MD LLC
• Tamara Lynn Powers, PT
• Prakash G Sane MD SC
• Prescriptive Wellness LLC
• Primary Care for You LTD.
• Provision Home Healthcare, Inc

• All providers in Hazel Crest, IL
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.

Verify at the official NPI Registry.