DR. MARK AVERY FULLER (MD) – Internal Medicine Physician, NPI 1124055561
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
216 GENERAL PRACTICE in MI
Loading map...
Provider Addresses for DR. MARK AVERY FULLER (MD)
Aspirus Ironwood Hospital, N10561, Grandview Lane, Siemens, Ironwood, Gogebic County, Michigan, 49938, United States
GRANDVIEW HOSPITAL
IRONWOOD, MI 499384828
Phone: (906) 932-6211
Type: Location
36745 AIKEN RD
BAYFIELD, WI 548144579
Phone: (715) 779-3707
Fax: (715) 779-3362
Type: Location
638, Lake Avenue, Ironwood, Gogebic County, Michigan, 49938, United States
IRONWOOD, MI 499381424
Phone: (906) 364-7105
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2022-07-19
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 |
|---|---|---|---|---|
| I20220719002767 | I | General Practice | WI | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 145 | 67 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 137 | 68 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 106 | 59 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 72 | 49 | $0 |
| 83036 | Hemoglobin a1c level | 63 | 37 | $0 |
Insurance plans in this area (ZIP 49938)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| C H I R O P R A C T I C | WI | |
| P O D I A T R Y | WI | |
| Physical Therapist In Private Practice | WI | |
| Physician Assistant | WI | |
| - | AZ | |
| P O D I A T R Y | WI | |
| Marriage And Family Therapist | WI | |
| Internal Medicine | MN | |
| P O D I A T R Y | WI | |
| Marriage And Family Therapist | WI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.