NPIMap

Individual provider Active NPI

Mark A Fulton, M.D.

  • Neurological Surgery Physician
  • Melbourne, FL
National Provider Identifier
1962409169
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME105861 Issued in FL
Practice address
1251 S Hickory St
Melbourne, FL 32901-3221
Phone
(321) 434-3420
Fax
(321) 434-3423
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME105861 FL Primary

Addresses

Primary practice location

1251 S Hickory St
Melbourne, FL 32901-3221

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-1981

Other identifiers 3

IdentifierTypeStateIssuer
001679400MedicaidFL
CS864XOtherFLMEDICARE
CS864YOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000641 FL Practitioner - Neurosurgery 4082693767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Utah School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians
Health First Physician Specialties IncGroup PAC ID 9537229646, 58 clinicians

Practice addresses (Care Compare)

1251 Hickory St
Melbourne, FL 32901-3221
Phone (321) 434-3420

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion42
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME105861FLMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC Neurological Surgery CurrentSince Mar 31, 2014 Accepting new patients
Health First Physician Specialties Inc CurrentSince May 5, 2015 Accepting new patients
Health First Medical Group, LLC CurrentSince Mar 31, 2014 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Somc Medical Care Foundation, Inc. Past Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 404
Cocoa Beach, FL 32931
Phone (321) 868-2778

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1251 Hickory St
Melbourne, FL 32901
Phone (321) 434-3420

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: mfulton26548@epicdirect.hf.org
  • Direct secure messaging: mark.fulton.1@8042.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1962409169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-1981",
            "fax_number": "321-951-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013221",
            "telephone_number": "321-434-3420",
            "fax_number": "321-434-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME105861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001679400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CS864X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CS864Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.