Patrick J. Fullerton, D.O.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

OS8087 Issued in FL

Practice address

6909 Old Highway 441 S Ste 222
Mount Dora, FL 32757-7039

Phone

(352) 441-9803

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, TX2 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 Osteopathy

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: patrick.fullerton.1@33769.direct.athenahealth.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.

• Central Florida Hospitalist Partners PA

  • Hospitalist Physician
  • Orlando, FL
  • NPI 1558381921
  Medicare reassignment NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• Muqeet Siddiqui, MD, LLC

  • Family Medicine Physician
  • Ocoee, FL
  • NPI 1558616482
  Medicare reassignment NPD
• Polk Emergency Group LLC

  • Emergency Medicine Physician
  • Bartow, FL
  • NPI 1558338574
  Medicare reassignment NPD
• Rmed LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1508815358

  Family Medicine

  Medicare reassignment NPD
• Tampa Bay Emergency Physicians LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1114977428
  Medicare reassignment NPD
• VMD Primary Providers Central Florida PLLC

  • Family Medicine Physician
  • Saint Cloud, FL
  • NPI 1134738974
  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  FL

  Medicare reassignment
• Rmed LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1205476793
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1811039555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6909 OLD HIGHWAY 441 S STE 222",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327577039",
            "telephone_number": "352-441-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 OLD HIGHWAY 441 S STE 222",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327577039",
            "telephone_number": "352-441-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "PATRICK",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS8087",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8087",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "OS8087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015379100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "OS8087",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Franz, RBT
• Sidnee Frederickson
• Karina Friman, PHARMD.
• Tiffany Fruth, PHARMD
• Veronica Lee Frye, M.A., CFY-SLP
• Christopher Fulton
• Funshine Therapy LLC
• Layna Christine Gamwell, APRN
• Mayra Garcia Saucedo
• Kristina Garcia

• Pain Medicine Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.