Individual provider Active NPI

Derek J Fulcher, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1740568526
Registry record updated Jan 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
47867 Issued in AZ
Practice address
350 W Thomas Rd Surgical Suite
Phoenix, AZ 85013
Phone
(602) 406-3451
Fax
(602) 406-7135
NPI assigned
Jul 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 6416 NE
Anesthesiology Physician 207L00000X 47867 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd Surgical Suite
Phoenix, AZ 85013

Mailing address

350 W Thomas Rd Surgical Suite
Phoenix, AZ 85013
Phone (602) 406-3451

Other practice location 1

1850 N Central Ave
Suite 1600
Phoenix, AZ 85004-4527
Phone (602) 744-4765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20131216000036 AZ Practitioner - Anesthesiology 0648407858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arizona College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

500 W Thomas Rd
680 DHMG St Joseph'S Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6416NEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sjhmc Physician Services CurrentSince Jan 1, 2024 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients

Locations

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

File 56765
Los Angeles, CA 90074

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1740568526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD SURGICAL SUITE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-3451",
            "fax_number": "602-406-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD SURGICAL SUITE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-3451",
            "fax_number": "602-406-7135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 N Central Ave",
            "address_2": "Suite 1600",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850044527",
            "country_code": "US",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULCHER",
        "first_name": "DEREK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-28",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "6416",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "47867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.