Ithiel Loken Ames Fuller, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

67242 Issued in CT

Practice address

17 Belmont Ave
Anesthesiology Dept
Brattleboro, VT 05301-7601

Phone

(802) 257-8220

NPI assigned

Apr 25, 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

Medicare fee-for-service enrollment

Enrolled in VT, WI2 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

Specialty

Anesthesiology

Education

Virginia Commonwealth University, School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCHS Hospitals IncGroup PAC ID 5698071173, shared by 28 NPIs, 1,195 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center - Eau Claire Hospital, Eau Claire, WI, CCN 520210

Merit-based Incentive Payment System (MIPS)

Final score

80.58 of 100Reported as group

Quality

55.5

Promoting interoperability

100

Improvement activities

40

Cost

71.46

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.

• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment NPD
• Flambeau Hospital Inc

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment NPD
• Flambeau Hospital Inc

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434

  Anesthesiology

  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Critical Access Hospital
  • Ladysmith, WI
  • NPI 1952890873
  Medicare reassignment NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  VT

  Medicare reassignment NPD
• Memorial Hospital Inc

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Beaver Dam Community Hospitals Inc

  • Pharmacy
  • Beaver Dam, WI
  • NPI 1295771780
  NPD
• MCHS Hospitals Inc

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Minocqua, WI
  • NPI 1942854716
  NPD

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

• MCHS Hospitals Inc

  • General Acute Care Hospital
  • Eau Claire, WI
  • NPI 1952809816
  Care Compare affiliation

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1821217746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "802-760-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BELMONT AVE",
            "address_2": "ANESTHESIOLOGY DEPT",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017601",
            "telephone_number": "802-257-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016118",
            "country_code": "US",
            "telephone_number": "715-858-4610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ITHIEL",
        "middle_name": "LOKEN AMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "84251",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VT",
            "license": "0420011774",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "67242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Fratea Jr., R.PH.
• Haley Frechette, PHARMD
• Rya M Freeland, MSW LICSW
• Francine Freeman, M.ED, MA, CCC-SLP
• Wendy Mallinson Friesen, MA, MFT
• Amy S Gadowski, M.D.
• Gregory R Gadowski, M.D.
• Eric Daniel Gallagher, MD
• Garden Path Elder Living, Inc.
• Elizabeth A Gardner, LCMHC

• Anesthesiology Physician in Brattleboro, VT
• Providers in Brattleboro, VT by specialty
• Anesthesiology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.