ERIN NICOLE FULLER (MD) – Dermatology Physician, NPI 1730475633

ERIN NICOLE FULLER (MD) is a healthcare provider. based in Stockton, California. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. A133947 (CA). The NPI Number for ERIN NICOLE FULLER (MD) is 1730475633

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
ERIN NICOLE FULLER (MD)
NPI
1730475633
Phone
(209) 957-3821
Address
2545 W HAMMER LN
Enumeration Date
20 June 2011
Last Update Date
31 December 2020

Doctor Profile

Medical School Name
UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE
Secondary Phone
8085993780
Graduation Year
2011 (15 years ago)
PAC ID
4587988423
Group Practice PAC ID
8224097894
Professional Enrollment ID
I20201230001456
Address ID
HI968132440HO1380XSTXX314
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:14State licenses:2Digital endpointsOther names

2,141 DERMATOLOGY in CA

Provider Addresses for ERIN NICOLE FULLER (MD)

  • 2545 W HAMMER LN

    STOCKTON, CA 952092839

    Phone: (209) 957-3821

    Type: Location

  • 1380 LUSITANA ST

    STE 412

    HONOLULU, HI 968132440

    Phone: (808) 599-3780

    Fax: (808) 538-1672

    Type: Mailing

  • 377 KEAHOLE ST

    HONOLULU, HI 968253405

    Phone: (808) 599-3780

    Type: Location

  • 2545 W Hammer Ln

    Stockton, CA 952092839

    Phone: (209) 957-3821

    Type: Location

  • 1380 Lusitana St Ste 412

    Honolulu, HI 968132440

    Phone: (808) 599-3780

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 94 Open Payments records for all available years, with a total value of $2,311.

Total Amount is formed as General ($2,311) + Research ($0) + Ownership ($0) = $2,311.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($495).

Total Amount

$2,311

General + Research + Ownership

Payments

94

Total payment records

General Amount

$2,311

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2020-12-30

PECOS data refreshed: 2026-06-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201230001456IDermatologyHITBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes269183$0
17003Destruction of precancer skin growth, 2-14 growths23247$0
17110Destruction of skin growth, 1-14 growths13997$0
99203New patient office or other outpatient visit, 30-44 minutes132132$0
99214Established patient office or other outpatient visit, 30-39 minutes12975$0
View full utilization report →

Insurance plans in this area (ZIP 95209)

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Provider's Procedures

ERIN NICOLE FULLER (MD) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYCA11101Biopsy of each additional growth of skin and/or tissue9171

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224097894View full group profile
NameSpecialtyState
D E R M A T O L O G YVA
D E R M A T O L O G YHI
D E R M A T O L O G YHI
-HI

Reviews

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Frequently asked questions

Can I use this page to confirm ERIN NICOLE FULLER (MD)'s NPI?
Yes. ERIN NICOLE FULLER (MD) is listed with NPI 1730475633 in the public NPI dataset.
Is ERIN NICOLE FULLER (MD) still practicing?
ERIN NICOLE FULLER (MD) is currently listed as active in the public NPI registry.
What is ERIN NICOLE FULLER (MD) best known for clinically?
Directory data describes ERIN NICOLE FULLER (MD) with Dermatology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for ERIN NICOLE FULLER (MD)?
ERIN NICOLE FULLER (MD)'s geographic hint is Stockton, California in our summary view.
Why does ERIN NICOLE FULLER (MD) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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