Tyler Fulks, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01082236A Issued in IN

Practice address

720 Eskenazi Ave
Ft 3
Indianapolis, IN 46202

Phone

(317) 880-3860

Fax

(317) 880-0545

NPI assigned

Jun 23, 2016

Last updated

Jun 23, 2019By the provider in NPPES

Sex

Male

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 IN, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Southern Illinois University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Emergency Department Specialists LTDGroup PAC ID 5193627727, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Midwest Emergency Department Specialists LTD

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1245263367
  Medicare reassignment Care Compare group NPD
• Icem-Wishard LLC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1629304134
  Medicare reassignment NPD
• Indiana University Health Care Associates, Inc

  dba IU Health Physicians

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561248000000",
    "number": "1548611296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "address_2": "FT 3",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-880-3860",
            "fax_number": "317-880-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "address_2": "FT 3",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-880-3860",
            "fax_number": "317-880-0545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627023757",
            "country_code": "US",
            "telephone_number": "217-545-3518",
            "fax_number": "217-545-2711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULKS",
        "first_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2019-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01082236A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysia Fuhrmann, BCBA
• Monica Fuhs
• Ayaka Fujihashi, MD
• Zachary Bennett Fulkerson, MD., PHD
• Stephanie Marie Fulks, NP
• Full Circle Family Services LLC.
• Full Embrace Home Care LLC
• Full Embrace Medical Equipment & Supplies LLC
• Abigail Fuller, RBT
• Adasia Fuller

• Emergency Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2019; 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.