Madeline Fullerton, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5475 Issued in MA

Practice address

45 Dimock St
Roxbury, MA 02119-1208

Phone

(617) 442-8800

Fax

(617) 427-4566

NPI assigned

Aug 4, 2021

Last updated

Aug 4, 2021By the provider in NPPES

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 MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ophthalmic Consultants of Boston IncGroup PAC ID 4789651498, 68 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ophthalmic Consultants of Boston, Inc.

  dba Ophthalmic Consultants of Boston

  • Ophthalmology Physician
  • Boston, MA
  • NPI 1932146594
  Medicare reassignment Care Compare group NPD
• Ophthalmic Consultants of Boston, Inc

  • Eyewear Supplier
  • East Weymouth, MA
  • NPI 1851966162

  Optometrist

  NPD
• Ophthalmic Consultants of Boston, Inc.

  dba Ophthalmic Consultants of Boston

  • Ophthalmology Physician
  • West Yarmouth, MA
  • NPI 1437374428
  NPD

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1528732500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800",
            "fax_number": "617-427-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-8800",
            "fax_number": "617-427-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "MADELINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaneka Franklin
• Leona M. Franklin, PH.D.
• Ingrid Nascimento Fredkin
• Minoucheka Frejuste
• Charice Fuller
• Xenia Funes
• Katonya Gaines, M.ED
• Idly Galette
• Gallery Eyecare, LLC
• Gallery Eyecare, LLC

• Optometrist in Roxbury, MA
• Providers in Roxbury, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.