Maria Teresa Cervantes-Fullmer, FNP

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

46717 Issued in ID

Practice address

3245 Channing Way
Idaho Falls, ID 83404-7536

Phone

(208) 227-2790

Fax

(208) 227-2735

NPI assigned

Oct 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advanced Home Health Home health agency, Idaho Falls, ID, CCN 137116
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074
• Lost Rivers Medical Center Hospital, Arco, ID, CCN 131324
• Teton Valley Hospital Hospital, Driggs, ID, CCN 131313

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maria.cervantesfullmer@hca3.eclinicaldirectplus.com
• Direct secure messaging: mcervantesfullmer@tetoncancer.direct.varian.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.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• Eirmc Hospitalist Services LLC

  • Internal Medicine Physician
  • Idaho Falls, ID
  • NPI 1144502071
  Medicare reassignment NPD
• Mountain View Hospital Physician Organization

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1073834529
  NPD (past)

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

• Advanced Home Health and Hospice

  • Home Health Agency
  • Idaho Falls, ID
  • NPI 1366686826
  Care Compare affiliation
• Advanced Home Health and Hospice

  • Home Health Agency
  • Pocatello, ID
  • NPI 1457858052
  Care Compare affiliation
• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1114481447
  Care Compare affiliation
• Lost Rivers Medical Center

  • Critical Access Hospital
  • Arco, ID
  • NPI 1114925047
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Teton Valley Health Care Inc

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  Care Compare affiliation

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1477020303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741716",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047536",
            "telephone_number": "208-227-2790",
            "fax_number": "208-227-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES-FULLMER",
        "first_name": "MARIA",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ID",
            "license": "46717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celebration Speech, Inc
• Center for Aesthetics PC
• Center for Sight PLLC
• Center for Surgery PLLC
• Center for Vision and Learning, PLLC
• Chamberlain General Surgery PA
• David J Chamberlain, D.O.
• John D Chambers Jr., M.D.
• Mark Aaron Chambers, DDS
• Jon F Champlin, CRNA

• Hematology & Oncology Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Hematology & Oncology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.