Justin Scott Fuller, PA

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

470 NE a St
Madras, OR 97741-1844

Phone

(541) 475-4800

Fax

(541) 475-4805

NPI assigned

Jul 11, 2025

Last updated

Apr 16, 2026By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Madras Hospital, Madras, OR, CCN 381324

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfuller225951@secure.stcharleshealthcare.org

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.

• St. Charles Health System, Inc.

  dba St. Charles Medical Group

  • Family Medicine Physician
  • Bend, OR
  • NPI 1023331303
  Medicare reassignment NPD
• St. Charles Health System, Inc.

  dba St. Charles Prineville

  • Critical Access Hospital
  • Prineville, OR
  • NPI 1710160445
  Medicare reassignment NPD
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Medicare reassignment
• St. Charles Health System, Inc.

  dba St. Charles Medical Center - Bend

  • Rehabilitation Hospital Unit
  • Bend, OR
  • NPI 1154343150
  NPD
• St. Charles Health System, Inc.

  dba St. Charles Family Care - Prineville

  • Rural Health Clinic/Center
  • Prineville, OR
  • NPI 1407178528
  NPD
• St. Charles Health System, Inc.

  dba The Center at St. Charles Medical Equipment

  • Specialist
  • Bend, OR
  • NPI 1700697935
  NPD

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

• St. Charles Health System, Inc.

  dba St. Charles - Madras

  • Critical Access Hospital
  • Madras, OR
  • NPI 1356389894
  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1609767227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NE A ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411844",
            "telephone_number": "541-475-4800",
            "fax_number": "541-475-4805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JUSTIN",
        "middle_name": "SCOTT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-11",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfuller225951@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "470 NE A St",
            "city": "Madras",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977411844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Lynn Fiocchi, PMHNP
• Robbin Webber Foster, L.C.S.W. (M.S.W.)
• Candace Rose Frantz, RN
• Fresenius Medical Care Dialysis Services - Oregon, LLC (Fresenius Medical Care Madras Dialysis)
• Kortney Fritts, QMHP-R
• Lydia Trujillo Galan, EPDH
• Aldo Garcia, CRM
• Jimmy Garcia, QMHP-R
• Melinda Garcia, CADC
• Gary Dehm, DMD

• Student in an Organized Health Care Education/Training Program in Madras, OR
• Providers in Madras, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.