KIMBERLEY ANN FULTON (P.A.) – Physician Assistant, NPI 1043218126
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for KIMBERLEY ANN FULTON (P.A.)
600, Park Avenue, Grand Haven, Ottawa County, Michigan, 49417, United States
600 PARK AVENUE
GRAND HAVEN, MI 494172173
Phone: (616) 847-8700
Fax: (616) 847-1049
Type: Mailing
1445 SHELDON RD STE 300
GRAND HAVEN, MI 494172479
Phone: (616) 296-1500
Fax: (616) 296-1502
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2024-10-17 • Largest payer in this snapshot: Lilly USA, LLC ($125).
Total Amount
$125
General + Research + Ownership
Payments
1
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $125 |
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: 2006-10-24
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 |
|---|---|---|---|---|
| I20061024000129 | I | Physician Assistant | MI | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 43 | 32 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 22 | 22 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 19 | 14 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 13 | $0 |
Insurance plans in this area (ZIP 49417)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| - | MI | |
| Addiction Medicine, Family Practice | IL | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI |
Reviews
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