Michael W Fuller, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

265403 Issued in NY

Practice address

48 East St
Fort Edward, NY 12828-1811

Phone

(518) 824-8630

Fax

(518) 824-2302

NPI assigned

Feb 6, 2009

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

Enrolled in NY

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

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glens Falls Hospital IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfuller98703@albanymed.direct-ci.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.

• Glens Falls Hospital Inc.

  • Family Medicine Physician
  • Glens Falls, NY
  • NPI 1336198217
  Medicare reassignment Care Compare group NPD
• Glens Falls Hospital Inc

  • Community/Retail Pharmacy
  • Glens Falls, NY
  • NPI 1619990991
  NPD
• Glens Falls Hospital Inc

  • General Acute Care Hospital
  • Glens Falls, NY
  • NPI 1871606764
  NPD (past)

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

• Glens Falls Hospital Inc

  • General Acute Care Hospital
  • Glens Falls, NY
  • NPI 1871606764
  Care Compare affiliation

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1851530398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300",
            "fax_number": "518-824-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 EAST ST",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281811",
            "telephone_number": "518-824-8630",
            "fax_number": "518-824-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-06",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "265403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03459703",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Hudson Nursing Center, Inc.
• Fort Hudson Nursing Center, Inc.
• Fort Hudson Social Day Program
• Maura D Fox, M.S.CCC-SLP,NBCT
• Kenneth S France, MD
• Philip Joseph Gara Jr., MD FACP
• Lisa Goodrich, LPN
• Laurel Green, LMSW
• Sasha Grems, RN
• Suzanne Hackert, LCSW-R

• Family Medicine Physician in Fort Edward, NY
• Providers in Fort Edward, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.