Individual provider Active NPI

Andrea B Fulcomer, PA-C

  • Physician Assistant
  • Fitchburg, WI
National Provider Identifier
1972552131
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7152 Issued in WI
Practice address
5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376
Phone
(608) 274-5300
NPI assigned
May 8, 2006
Last updated
Oct 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7152 WI Primary
Physician Assistant 363A00000X 50-00-1216 OH
Physician Assistant 363A00000X 085.004757 IL

Addresses

Primary practice location

5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address afulcomer913479@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161222000825 IL Practitioner - Physician Assistant 2567642655 Reassigns benefits to 1 organization
I20251023003704 WI Practitioner - Physician Assistant 2567642655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376
Phone (608) 274-5300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.004757ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Jan 1, 2017 Accepting new patients
Swedishamerican Hospital CurrentSince Jan 1, 2017 Accepting new patients
Blanchard Valley Medical Associates, Inc. Current Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 8, 2025 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 8, 2025 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2404 Charles St
Rockford, IL 61108
Phone (779) 696-7910

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

3505 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-0300

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

200 W Pearl St
Findlay, OH 45840
Phone (419) 424-0380

5543 E Cheryl Pkwy
Fitchburg, WI 53711
Phone (608) 263-7740

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1972552131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5543 E CHERYL PKWY",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115376",
            "telephone_number": "608-274-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULCOMER",
        "first_name": "ANDREA",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7152",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-00-1216",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afulcomer913479@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "3505 N Bell School Rd",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611146624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.