Active NPI
Paul Russell Fulton, ED.D.
- Forensic Psychologist
- Newton Center, MA
National Provider Identifier
1558412296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 4355
- Practice address
- 23 Pleasant St
Suite 2
Newton Center, MA 02459-1836 - Phone
- (617) 244-0131
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4355 | MA | |
| Forensic Psychologist | 103TF0200X | 4355 | MA | Primary |
| Psychologist | 103T00000X | 4355 | MA |
Addresses
Primary practice location
23 Pleasant St
Suite 2
Newton Center, MA 02459-1836
Mailing address
35 Pleasant St
Newton Center, MA 02459-1812
Phone (617) 244-0131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WO4223 | Other | MA | BLUE CROSS PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4355 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1558412296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 PLEASANT ST",
"city": "NEWTON CENTER",
"state": "MA",
"postal_code": "024591812",
"telephone_number": "617-244-0131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 PLEASANT ST",
"address_2": "SUITE 2",
"city": "NEWTON CENTER",
"state": "MA",
"postal_code": "024591836",
"telephone_number": "617-244-0131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "PAUL",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4355",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MA",
"license": "4355",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "4355",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER ID",
"identifier": "WO4223",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newton Center, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.