JON D FULLER (MD) – Surgery Physician, NPI 1225080765
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
300 GENERAL SURGERY in AR
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Provider Addresses for JON D FULLER (MD)
7, Shackleford West Boulevard, Little Rock, Pulaski County, Arkansas, 72211, United States
LITTLE ROCK, AR 722113886
Phone: (501) 664-5860
Fax: (501) 664-0889
Type: Location
603-2 N PROGRESS AVE STE 200
SILOAM SPRINGS, AR 727614206
Phone: (479) 215-3040
Fax: (479) 238-1182
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $453.
Total Amount is formed as General ($453) + Research ($0) + Ownership ($0) = $453.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Ethicon US, LLC ($249).
Total Amount
$453
General + Research + Ownership
Payments
9
Total payment records
General Amount
$453
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ethicon US, LLC | $249 |
| Davol Inc. | $154 |
| Medtronic, Inc. | $22 |
| Novo Nordisk Inc | $14 |
| Janssen Pharmaceuticals, Inc | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-11-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051115001005 | I | General Surgery | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 59 | 44 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 55 | 40 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 55 | 40 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 40 | 40 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 40 | 36 | $0 |
Insurance plans in this area (ZIP 72211)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AR | |
| Nurse Practitioner | AR | |
| General Surgery | AR | |
| Internal Medicine | AR | |
| - | AR | |
| Nurse Practitioner | AR | |
| - | AR |
Reviews
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