Individual provider Active NPI

Barbara L Fuller, MD

  • Hematology & Oncology Physician
  • Hobart, IN
National Provider Identifier
1972545804
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
01034701A Issued in IN
Practice address
1600 S Lake Park Ave
Suite1101
Hobart, IN 46342-6641
Phone
(219) 947-1795
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036056161 IL
Hematology & Oncology Physician 207RH0003X 01034701A IN Primary

Addresses

Primary practice location

1600 S Lake Park Ave
Suite1101
Hobart, IN 46342-6641

Mailing address

1600 S Lake Park Ave
Suite 1101
Hobart, IN 46342-6641
Phone (219) 947-1795

Other identifiers 3

IdentifierTypeStateIssuer
036056161MedicaidIL
100394430MedicaidIN
100213850FMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20120104000833 IN Practitioner - Hematology/Oncology 4688655913 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Catherine Hospital Inc. CurrentSince May 1, 2015 Accepting new patients
St Catherine Hospital Inc CurrentSince May 1, 2015 Accepting new patients
Northwest Cancer Centers, PC Hematology & Oncology CurrentSince Jul 1, 2014 Accepting new patients
Community Care Network Inc Past Accepting new patients
Cressa Perish MD SC Past Accepting new patients
Monroe Medical Associates, SC Hematology & Oncology PastSince Jan 1, 1990 Accepting new patients

Locations

1001 Calumet Ave
Dyer, IN 46311
Phone (219) 924-8178

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1600 S Lake Park Ave
Ste 1101
Hobart, IN 46342
Phone (219) 947-1795

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1972545804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S LAKE PARK AVE",
            "address_2": "SUITE 1101",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426641",
            "telephone_number": "219-947-1795",
            "fax_number": "219-947-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S LAKE PARK AVE",
            "address_2": "SUITE1101",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426641",
            "telephone_number": "219-947-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BARBARA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036056161",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01034701A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056161",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100394430",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100213850F",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobart, IN

Sources for this page

Verify at the official NPI Registry.