Robin H Fuller, PA C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

003118 Issued in NY

Practice address

37 W Garden St
Suite 105
Auburn, NY 13021-2662

Phone

(315) 252-0000

Fax

(315) 252-0070

NPI assigned

Feb 9, 2007

Last updated

Sep 16, 2016By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Medical Pain Management of Cny, PC

  • Pain Medicine (Anesthesiology) Physician
  • Syracuse, NY
  • NPI 1467632182
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1811038011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "address_2": "AMMS, PC",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-252-0000",
            "fax_number": "315-252-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 W GARDEN ST",
            "address_2": "SUITE 105",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130212662",
            "telephone_number": "315-252-0000",
            "fax_number": "315-252-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ROBIN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "003118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02903446",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Frawley, LMSW
• Richard John Freeman Sr., MD
• Danielle Friedel
• Kristen Marie Frost, CNM
• Paul Xiaobei Fu, M.D.
• Douglas Fye, P.T., D.P.T., O.C.S.
• G Michael Palmer MD PC (Finger Lakes Radiology)
• Daniel Gabriel, MD
• Heather E Gage, LCSW
• Flora Marie Gagliostro, LMSW

• Surgical Physician Assistant in Auburn, NY
• Providers in Auburn, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.