Active NPI
Barbara L Fuller, MD
- Hematology & Oncology Physician
- Hobart, IN
National Provider Identifier
1972545804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 01034701A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036056161 | Medicaid | IL | |
| 100394430 | Medicaid | IN | |
| 100213850F | Medicaid | IN |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Catherine Hospital Inc. | Current | Accepting new patients | |
| St Catherine Hospital Inc | Current | Accepting new patients | |
| Northwest Cancer Centers, PC | Hematology & Oncology | Current | 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 | Past | 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.
-
- Internal Medicine Physician
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Hematology & Oncology, IN
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- NPI 1568806057
-
- Family Medicine Physician
- St John, IN
- NPI 1457610487
-
- Family Medicine Physician
- Flossmoor, IL
- NPI 1467553743
-
- Hematology & Oncology Physician
- Tinley Park, IL
- NPI 1588607923
Hematology & Oncology
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.