DOMINIQUE NOELLE FULK (OD) – Optometrist, NPI 1073362190

DOMINIQUE NOELLE FULK (OD) is a healthcare provider. based in Pikeville, Kentucky. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2377DT (KY). The NPI Number for DOMINIQUE NOELLE FULK (OD) is 1073362190

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
DOMINIQUE NOELLE FULK (OD)
NPI
1073362190
Phone
Not provided
Address
147 SYCAMORE ST OFC 401B
Enumeration Date
13 May 2024
Last Update Date
13 May 2024

Doctor Profile

Medical School Name
UNIVERSITY OF PIKEVILLE, KENTUCKY COLLEGE OF OSTEOPATHIC MED
Secondary Phone
6062185528
Graduation Year
2022 (4 years ago)
PAC ID
0345784740
Group Practice PAC ID
6709120942
Professional Enrollment ID
I20240626002895
Address ID
KY415019118PI147XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

700 OPTOMETRY in KY

Provider Addresses for DOMINIQUE NOELLE FULK (OD)

  • 147 SYCAMORE ST OFC 401B

    PIKEVILLE, KY 415019118

    Phone:

    Mailing address matches the actual address.

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 $310.

Total Amount is formed as General ($310) + Research ($0) + Ownership ($0) = $310.

Last reported payment date: 2024-11-27 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($50).

Total Amount

$310

General + Research + Ownership

Payments

9

Total payment records

General Amount

$310

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-27

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: 2024-06-26

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240626002895IOptometryKYTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 41501)

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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: 6709120942View full group profile
NameSpecialtyState
O P T O M E T R YKY
-KY
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YID
O P T O M E T R YKY
-TX
O P T O M E T R YKY
O P T O M E T R YCA
O P T O M E T R YKY

Reviews

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Frequently asked questions

How is DOMINIQUE NOELLE FULK (OD) identified in CMS data?
CMS-hosted NPPES data lists DOMINIQUE NOELLE FULK (OD) with NPI 1073362190.
Can I rely on DOMINIQUE NOELLE FULK (OD) being an active provider?
As of the registry snapshot, DOMINIQUE NOELLE FULK (OD) is marked active.
What taxonomy line describes DOMINIQUE NOELLE FULK (OD)?
For research purposes, treat DOMINIQUE NOELLE FULK (OD) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DOMINIQUE NOELLE FULK (OD)?
DOMINIQUE NOELLE FULK (OD)'s geographic hint is Pikeville, Kentucky in our summary view.
Is the information about DOMINIQUE NOELLE FULK (OD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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