DOUGLAS R FULLEN (MD) – Dermatopathology (Pathology) Physician, NPI 1730260183
Dermatopathology (Pathology) Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DOUGLAS R FULLEN (MD)
South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States
ANN ARBOR, MI 481081633
Phone: (734) 647-5299
Type: Mailing
Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States
ANN ARBOR, MI 481095000
Phone: (734) 936-4000
Type: Location
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: 2010-02-25
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 |
|---|---|---|---|---|
| I20100225000872 | I | Pathology | 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 |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 584 | 389 | $0 |
| 88321 | Surgical pathology consultation and report on referred slides prepared elsewhere | 120 | 118 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 116 | 37 | $0 |
| 88350 | Antibody evaluation, each additional single antibody stain procedure | 88 | 19 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 75 | 50 | $0 |
Insurance plans in this area (ZIP 48108)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PATHOLOGY | MI | 88312 | Special stained specimen slides to identify organisms including interpretation and report | 71 | 33 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | FL | |
| Physical Medicine And Rehabilitation | MI | |
| A N E S T H E S I O L O G Y | MI | |
| Internal Medicine, Pediatric Medicine | IL | |
| - | MI | |
| Physician Assistant | MI |
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