Megan Fuller, M.D.

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

29200 Issued in NE

Practice address

3401 Civic Center Blvd
Division of Pediatric Surgery
Philadelphia, PA 19104-4319

Phone

(217) 553-6708

Fax

(217) 553-6708

NPI assigned

May 31, 2007

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 NE, IA2 enrollments

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 2

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 and National Provider Directory roles.

• Father Flanagan'S Boys' Home

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1295821825

  IA

  Medicare reassignment NPD
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment NPD
• Children'S Hospital & Medical Center

  • Children's Hospital
  • Omaha, NE
  • NPI 1346297843
  NPD (past)
• ENT Services PC

  • Otolaryngology Physician
  • Omaha, NE
  • NPI 1194822130
  NPD (past)
• Father Flanagan'S Boys Home

  • Psychologist
  • Boys Town, NE
  • NPI 1265405419
  NPD (past)
• Nebraska Pediatric Practice, Inc

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1144556333
  NPD (past)

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1780885202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC SURGERY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "217-553-6708",
            "fax_number": "217-553-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC SURGERY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "217-553-6708",
            "fax_number": "217-553-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MEGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "PA",
            "license": "MT205584",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NE",
            "license": "29200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Sharnetta Fuller, CRNP
• Collin Guthrie Fuller, M.D.
• David B Fuller, D.O.
• Joshua Fuller
• Karrianne Marie Fuller
• Stephanie Fuller, M.D.
• Steven Charles Fulop, M.D., M.S.
• Brian Laurence Fulton, MD
• Kathryn Fulton
• Rachel Fulton, MD

• Pediatric Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.