Brian William Fullem, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PO3445 Issued in FL

Practice address

1700 N McMullen Booth Rd
#C-2
Clearwater, FL 33759-2130

Phone

(727) 330-7646

Fax

(727) 330-7645

NPI assigned

Jun 29, 2006

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Elite Sports Podiatry, PA

  • Foot Surgery Podiatrist
  • Clearwater, FL
  • NPI 1356743207
  NPD Authorized official
• Bayshore Podiatry Center

  • Sports Medicine Podiatrist
  • Tampa, FL
  • NPI 1982688354
  NPD (past)
• Home Health Professionals Network

  • Home Health Agency
  • Hamden, CT
  • NPI 1326550666
  NPD (past)
• New Haven Podiatry Associates LLP

  • Podiatrist
  • New Haven, CT
  • NPI 1306854864
  NPD (past)
• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1922036086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N MCMULLEN BOOTH RD",
            "address_2": "#C-2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337592130",
            "telephone_number": "727-330-7646",
            "fax_number": "727-330-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N MCMULLEN BOOTH RD",
            "address_2": "#C-2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337592130",
            "telephone_number": "727-330-7646",
            "fax_number": "727-330-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLEM",
        "first_name": "BRIAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "556",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO3445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Frost, PA-C
• Mary Ann Frost, LMHC
• Stephen John Fulgieri
• Daxton Fulk
• Full Circle Orthopedics PLLC
• Suzanne M Fuller, OTR
• Josefina Dumagat Fullerton
• Fundora My Dentist. LLC
• Marcel Fundora, DMD
• Funshine Breeze LLC

• Foot Surgery Podiatrist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Foot Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.