Wendy P Fuller, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

022384 Issued in NY

Practice address

3317 Rochambeau Ave
Bronx, NY 10467-2846

Phone

(718) 470-8995

NPI assigned

Oct 3, 2017

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 NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: wfuller@montefioredirect.com

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1699285759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 BRONX BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701407",
            "telephone_number": "718-304-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 ROCHAMBEAU AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672846",
            "telephone_number": "718-470-8995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75-59 263rd Street",
            "address_purpose": "LOCATION",
            "city": "Glen Oaks",
            "state": "NY",
            "postal_code": "11004",
            "country_code": "US",
            "telephone_number": "718-470-8995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75-79 263rd St",
            "address_purpose": "LOCATION",
            "city": "Glen Oaks",
            "state": "NY",
            "postal_code": "11004",
            "country_code": "US",
            "telephone_number": "718-470-8995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 Bronx Blvd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104701407",
            "country_code": "US",
            "telephone_number": "718-304-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "WENDY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne E Fuller, M.D.
• Cassie Lynn Fuller, AU.D.
• Mariah Fuller, LMSW
• Paul Fuller
• Shanice Fuller
• Elizabeth Fulton
• Latoya Fulton
• Laura Karina Fumero Maduro, MD
• Fun With Speech Therapy
• Function in Motion Physical Therapy PC

• Clinical Psychologist in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.