Matthew David Fullmer, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

5151010511 Issued in MI

Practice address

1226 NE 7TH St
Grants Pass, OR 97526-1424

Phone

(541) 476-6636

NPI assigned

Jul 2, 2018

Last updated

Jul 8, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Ophthalmology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cascade Eyecare Center PCGroup PAC ID 7113999236, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.6 of 100Reported as group

Quality

82.02

Improvement activities

40

Cost

52.63

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://57c9cc78-a402-499f-957d-8bbee6939ebd.gastro.prod.fhir.ema-api.com/fhir/r4/
• Direct secure messaging: mdf@cascadeeye.emadirect.md
• Direct secure messaging: mdf@cec6636.ecldirect.net

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.

• Cascade Eyecare Center PC

  • Ophthalmology Physician
  • Grants Pass, OR
  • NPI 1295758696
  Medicare reassignment Care Compare group NPD
• Cascade Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Grants Pass, OR
  • NPI 1922022425
  NPD (past)

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1841786829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261424",
            "telephone_number": "541-476-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261424",
            "telephone_number": "541-476-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2022-07-08",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151010511",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "DO209577",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan M Frost, MD
• Kelly Fruth
• Gina Fry
• June Fryer, RPH
• Gary Fuller, R.PH.
• Julia Aenes Funaro, LMT
• Functional Flexion LLC
• Amy Furrow, B.S.
• Jesse T Gabbert, LMT
• Jesse H Gallagher, D.M.D.

• Student in an Organized Health Care Education/Training Program in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.