BRENT N FULTON (M.D.) – Sports Medicine (Family Medicine) Physician, NPI 1194708495
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
419 SPORTS MEDICINE in FL
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Provider Addresses for BRENT N FULTON (M.D.)
West International Speedway Boulevard, Daytona Beach, Volusia County, Florida, 32124, United States
DAYTONA BEACH, FL 32124
Phone: (386) 258-9502
Fax: (386) 239-9781
Type: Mailing
873 HULL RD UNIT 12
ORMOND BEACH, FL 32174
Phone: (386) 267-2965
Fax: (386) 603-6007
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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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: 2008-03-24
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 |
|---|---|---|---|---|
| I20080324000224 | I | Sports Medicine | FL | 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 |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 10,685 | 270 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 840 | 280 | $0 |
| 97750 | Test or measurement for functional capacity, each 15 minutes | 576 | 221 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 235 | 149 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 151 | 151 | $0 |
Insurance plans in this area (ZIP 32124)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| SPORTS MEDICINE | FL | 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 52 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O T O L A R Y N G O L O G Y | FL | |
| Nurse Practitioner | FL | |
| Physician Assistant | FL | |
| U R O L O G Y | FL | |
| Internal Medicine, Hematology/Oncology | FL | |
| Family Practice | FL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | FL | |
| - | - | |
| Emergency Medicine | FL | |
| Nurse Practitioner | TN |
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