NPIMap

Individual provider Active NPI

Brant R. Fulmer, M.D.

  • Urology Physician
  • Danville, PA
National Provider Identifier
1477521433
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD072746L Issued in PA
Practice address
100 North Academy Ave.
Danville, PA 17822
Phone
(570) 271-6328
Fax
(570) 271-6955
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME 104664 FL
Urology Physician 208800000X MD072746L PA Primary

Addresses

Primary practice location

100 North Academy Ave.
Danville, PA 17822

Mailing address

100 North Academy Ave.
Danville, PA 17822
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
001857502MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bfulmer75186@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080407000590 PA Practitioner - Urology 6204843121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Temple University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

1020 Thompson St
Jersey Shore, PA 17740-1729
Phone (570) 398-1991

1525 N Church St
Hazle Township, PA 18202-9383
Phone (570) 751-5900

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

27 Sandy LN
Lewistown, PA 17044-1310
Phone (717) 242-2711

4200 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 644-4200

4203 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 648-4010

5 Atrium CT
Selinsgrove, PA 17870-9017
Phone (570) 372-9933

Hospital & facility affiliations

  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Geisinger-Bloomsburg Hospital Hospital, Bloomsburg, PA, CCN 390003
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger Jersey Shore Hospital Hospital, Jersey Shore, PA, CCN 391300
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 104664FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Geisinger Clinic Past Accepting new patients
Geisinger Medical Center Past Accepting new patients

Locations

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

100 N Academy Ave
Danville, PA 17822

1525 N Church St
Hazle Township, PA 18202
Phone (570) 454-5222

Interoperability endpoints

  • Direct secure messaging: bfulmer75186@direct.geisinger.edu

Organizations & group practices 7

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.

Hospital & facility affiliations 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1477521433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVE.",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "17822",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVE.",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "17822",
            "telephone_number": "570-271-6328",
            "fax_number": "570-271-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMER",
        "first_name": "BRANT",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME 104664",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD072746L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001857502",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bfulmer75186@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 North Academy Ave.",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.