NPIMap

Individual provider Active NPI

Raymond D. Fuller, M.D.

  • Surgery Physician
  • Delaware, OH
National Provider Identifier
1356424899
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35061615 Issued in OH
Practice address
90 E William St
Delaware, OH 43015-2149
Phone
(740) 615-0450
Fax
(740) 615-0462
NPI assigned
Oct 20, 2006
Last updated
Apr 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35061615 OH Primary

Addresses

Primary practice location

90 E William St
Delaware, OH 43015-2149

Mailing address

5400 Frantz Rd
Suite 250
Dublin, OH 43016-4144

Other identifiers 1

IdentifierTypeStateIssuer
0165182MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040129000488 OH Practitioner - General Surgery 9537062666 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Ohio State University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magruder Medical Group LTDGroup PAC ID 1951675198, 13 clinicians

Practice addresses (Care Compare)

611 Fulton St
Suite C
Port Clinton, OH 43452-2008
Phone (419) 732-6500

615 Fulton St
Port Clinton, OH 43452-2001
Phone (419) 732-4009

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.49 of 100Reported as group
Quality
55.95
Promoting interoperability
89
Improvement activities
40
Cost
74.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35061615OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jun 1, 2016 Accepting new patients
Ohiohealth Corporation CurrentSince Jun 1, 2016 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Magruder Medical Group LTD Surgery CurrentSince Jul 16, 2020 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

90 E William St
Delaware, OH 43015
Phone (740) 363-1473

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

611 Fulton St
Ste C
Port Clinton, OH 43452
Phone (419) 732-6500

615 Fulton St
Port Clinton, OH 43452
Phone (419) 734-3131

4141 N Hampton Dr
Ste 100
Powell, OH 43065
Phone (614) 764-0200

4141 N Hampton Dr
Ste 103
Powell, OH 43065
Phone (740) 615-2850

100 Tippett Ct
Ste 101
Sunbury, OH 43074
Phone (740) 965-3123

Interoperability endpoints

  • Direct secure messaging: raymond.fuller@direct.magruderhospital.com

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 7

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1356424899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FRANTZ RD",
            "address_2": "SUITE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E WILLIAM ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152149",
            "telephone_number": "740-615-0450",
            "fax_number": "740-615-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "RAYMOND",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35061615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165182",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.