Emily Ellen Fulk, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7435-23 Issued in WI

Practice address

3400 Market LN
Kenosha, WI 53144-3430

Phone

(262) 551-4600

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score

83.15 of 100Reported as group

Quality

69.39

Promoting interoperability

100

Improvement activities

40

Cost

74.44

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: efulk689018@direct.froedtert.com

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.

• Froedtert South, Inc.

  • Family Medicine Physician
  • Kenosha, WI
  • NPI 1558305284
  Medicare reassignment Care Compare group NPD

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

• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1427831585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 CORNERSTONE XING APT 12",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531854540",
            "telephone_number": "309-530-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MARKET LN",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443430",
            "telephone_number": "262-551-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULK",
        "first_name": "EMILY",
        "middle_name": "ELLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "7435-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7435-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynore Rose Friscia, M.S., L.P.C.
• Alison D Fritschler, APNP
• Froedtert South, Inc.
• FS Outpatient Imaging Center LLC
• Fulfilling a Need,LLC
• Kevin J Fullin, MD FACC
• Patricia Fullin, ACUPUNCTURISTS
• Kaleigh E Fulmer, DDS
• Dequan M Gaddis Jr., CPHT
• Jui Siddharth Gaikwad

• Physician Assistant in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.

Verify at the official NPI Registry.