KRISTLE M FULLERTON – Clinical Social Worker, NPI 1124583729

KRISTLE M FULLERTON is a healthcare provider. based in Bel air, Maryland. specializing in CLINICAL SOCIAL WORKER. The NPI Number for KRISTLE M FULLERTON is 1124583729

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KRISTLE M FULLERTON
NPI
1124583729
Phone
(443) 643-2422
Address
802 BALTIMORE PIKE
Enumeration Date
7 February 2019
Last Update Date
7 February 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8883331345
Graduation Year
2018 (8 years ago)
PAC ID
7810239720
Group Practice PAC ID
1052688389
Professional Enrollment ID
I20190424002993
Address ID
MD210149506BE103XXSTXX500
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:7State licenses:0Digital endpointsOther names

2,276 CLINICAL SOCIAL WORKER in MD

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Provider Addresses for KRISTLE M FULLERTON

  • Retro Fitness, 802, Baltimore Pike, Locust Knoll, Harford County, Maryland, 21014, United States

    BEL AIR, MD 210144212

    Phone: (443) 643-2422

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2019-04-24

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190424002993IClinical Social WorkerMDTBD

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
90834Psychotherapy, 45 minutes14247$0
90837Psychotherapy, 1 hour3318$0
90832Psychotherapy, 30 minutes1914$0
90791Psychiatric diagnostic evaluation1111$0
View full utilization report →

Insurance plans in this area (ZIP 21014)

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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: 1052688389View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for KRISTLE M FULLERTON?
KRISTLE M FULLERTON — NPI 1124583729 — is the standard way to identify this listing.
Can I rely on KRISTLE M FULLERTON being an active provider?
As of the registry snapshot, KRISTLE M FULLERTON is marked active.
What taxonomy line describes KRISTLE M FULLERTON?
For research purposes, treat KRISTLE M FULLERTON as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Where is KRISTLE M FULLERTON based?
KRISTLE M FULLERTON is tied to Bel Air, Maryland in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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