Antonette Fuller

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

14117 Issued in CT

Practice address

2639 Main St
Glastonbury, CT 06033-2023

Phone

(860) 659-1329

NPI assigned

Nov 6, 2024

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians

MC Diagnostic of Connecticut, P.C.Group PAC ID 0941382113, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• MC Diagnostic of Connecticut, P.C.

  • Family Nurse Practitioner
  • Rocky Hill, CT
  • NPI 1386821932
  Medicare reassignment Care Compare group NPD
• Starling Physicians, PLLC

  • Internal Medicine Physician
  • Rocky Hill, CT
  • NPI 1467537290
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care Connecticut PLLC

  • Family Nurse Practitioner
  • Rocky Hill, CT
  • NPI 1548076086
  Medicare reassignment NPD
• Starling Physicians PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomfield, CT
  • NPI 1760355861
  NPD
• Starling Physicians, PLLC

  dba Starling Physicians PC

  • Mammography Clinic/Center
  • New Britain, CT
  • NPI 1720182991
  NPD (past)

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1952124091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332023",
            "telephone_number": "860-659-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ANTONETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "14117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Michelle Freed
• Jennifer Freeman, APRN
• Cecille Freilich, MD
• Thomas Freund, MD
• Michael Andrew Fuery, MD
• Shannon Funkhouser, ND
• Clint Galamgam, MSPT
• Kathleen Hope Gallagher, AGNP-C
• Thomas Galvin, D.D.S.
• Carol Jane Gammell, M.ED., M.A., LPC

• Family Nurse Practitioner in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.