Erin Nicole Fuller, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD-21157 Issued in HI

Practice address

377 Keahole St
Honolulu, HI 96825-3405

Phone

(808) 599-3780

NPI assigned

Jun 20, 2011

Last updated

Dec 31, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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 1

Specialty

Dermatology

Education

University of Hawaii John a. Burns School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dawson Dermatology LLCGroup PAC ID 8224097894, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.05 of 100Reported as apm

Quality

89.81

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Dawson Dermatology, LLC

  dba Dawson Dermatology

  • Specialist
  • Honolulu, HI
  • NPI 1194885582
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1730475633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "STE 412",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132440",
            "telephone_number": "808-599-3780",
            "fax_number": "808-538-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 KEAHOLE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253405",
            "telephone_number": "808-599-3780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2545 W Hammer Ln",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952092839",
            "country_code": "US",
            "telephone_number": "209-957-3821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1380 Lusitana St Ste 412",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132440",
            "country_code": "US",
            "telephone_number": "808-599-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A133947",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "HI",
            "license": "MD-21157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Kimo Fukuroda, DDS
• Taryn Fukuroku, PT
• Braxton Seiya Fukutomi
• Osamu Fukuyama, M.D.
• Bradley A Fuller, P.T.
• Ivette Fullerton, MSW
• Darryl Takayoshi Funai, A.T.C.
• David Fundakowski
• Andrew Fung, DPT
• Erica Fung, BCBA

• Dermatology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Dermatology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.