Active NPI
Daniel H Fulkerson, M.D.
- Neurological Surgery Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 01068116A
- Practice address
- 100 Navarre PL Ste 6600
South Bend, IN 46601-1173 - Phone
- (574) 647-8800
- Fax
- (574) 647-8896
- NPI assigned
- May 27, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 01068116A | IN | Primary |
Addresses
Primary practice location
100 Navarre PL Ste 6600
South Bend, IN 46601-1173
Mailing address
3245 Health Dr.
Suite 100
Granger, IN 46530-3245
Phone (547) 647-1840
Other practice location 1
500 Arcade Ave Ste 200
Elkhart, IN 46514-2485
Phone (574) 294-8404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200983330 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dhfulkerson@mybeacon.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Indiana University School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Navarre PL
6600 BMG N Central Neurosurgery SB
South Bend, IN 46601-1173
Phone (574) 647-8800
Hospital & facility affiliations
- Memorial Hospital of South Bend
- Elkhart General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
| Laminectomy or laminotomy (partial removal of spine bones) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Neurological Surgery | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
500 Arcade Ave
Ste 200
Elkhart, IN 46514
Phone (574) 293-3317
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
900 I St
Laporte, IN 46350
Phone (219) 324-1670
710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610
100 Navarre Pl
Ste 6600
South Bend, IN 46601
Phone (574) 232-7227
Interoperability endpoints
- dhfulkerson@mybeacon.cernerdirect.com
- dfulkerson1147638@direct.trinity-health.org
- dfulkerson10403@direct.franciscanalliance.org
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Neurological Surgery Physician
- South Bend, IN
- NPI 1861421141
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1386802387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 HEALTH DR.",
"address_2": "SUITE 100",
"city": "GRANGER",
"state": "IN",
"postal_code": "465303245",
"telephone_number": "547-647-1840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NAVARRE PL STE 6600",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011173",
"telephone_number": "574-647-8800",
"fax_number": "574-647-8896"
}
],
"practiceLocations": [
{
"address_1": "500 Arcade Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Elkhart",
"state": "IN",
"postal_code": "465142485",
"country_code": "US",
"telephone_number": "574-294-8404",
"fax_number": "574-523-1642",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FULKERSON",
"first_name": "DANIEL",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-27",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "IN",
"license": "01068116A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200983330",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dhfulkerson@mybeacon.cernerdirect.com",
"affiliation": "N",
"address_1": "500 Arcade Ave Ste 200",
"city": "Elkhart",
"state": "IN",
"country_code": "US",
"postal_code": "465142485",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.