SPENCER FULLER (MD, MPH) – Retina Specialist (Ophthalmology) Physician, NPI 1124513023

SPENCER FULLER (MD, MPH) is a healthcare provider. based in Reno, Nevada. specializing in OPHTHALMOLOGY. They hold the professional credentials MD, MPH. They hold a License No. 2018020280 (MO). The NPI Number for SPENCER FULLER (MD, MPH) is 1124513023

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
SPENCER FULLER (MD, MPH)
NPI
1124513023
Phone
(775) 737-9411
Address
5449 RENO CORPORATE DR STE 200
Enumeration Date
25 June 2018
Last Update Date
16 August 2024

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Secondary Phone
7757379411
Graduation Year
2018 (8 years ago)
PAC ID
4688052681
Group Practice PAC ID
5294906137
Professional Enrollment ID
I20240515001396
Address ID
NV895112626RE5449XDRXX401

Contacts

Secure Messaging
SFULLER583286@DIRECT.MED.UTAH.EDU
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness85
Years active:7State licenses:3Other namesUpdated within 12 months

141 OPHTHALMOLOGY in NV

Provider Addresses for SPENCER FULLER (MD, MPH)

  • 5449 RENO CORPORATE DR STE 200

    RENO, NV 895112626

    Phone: (775) 737-9411

    Type: Mailing

  • 660, South Euclid Avenue, Central West End, City of Saint Louis, Missouri, 63110, United States

    INTERNAL MEDICINE CAMPUS BOX 8121

    SAINT LOUIS, MO 631101010

    Phone: (314) 362-5000

    Type: Mailing

  • ONE BARNES-JEWISH HOSPITAL PLAZA

    ST. LOUIS, MO 63110

    Phone: (315) 362-5000

    Type: Location

  • 65 S MARIO CAPECCHI DR

    SALT LAKE CITY, UT 841320005

    Phone: (801) 316-8910

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $929.

Total Amount is formed as General ($929) + Research ($0) + Ownership ($0) = $929.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Genentech USA, Inc. ($333).

Total Amount

$929

General + Research + Ownership

Payments

16

Total payment records

General Amount

$929

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

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: 2024-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20220603000552IOphthalmologyUTTBD
I20240515001396IOphthalmologyNVTBD

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
92134Imaging of retina3939$0
67028Injection of drug into eye3232$0
View full utilization report →

Insurance plans in this area (ZIP 89511)

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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: 5294906137View full group profile
NameSpecialtyState
O P H T H A L M O L O G YNV
Physician AssistantNV

Reviews

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Frequently asked questions

What is the registry number for SPENCER FULLER (MD, MPH)?
The registry entry for SPENCER FULLER (MD, MPH) shows NPI 1124513023.
Does the public listing show SPENCER FULLER (MD, MPH) as active?
SPENCER FULLER (MD, MPH)'s NPI record reflects an active status in NPPES.
What type of care does SPENCER FULLER (MD, MPH) provide?
SPENCER FULLER (MD, MPH)'s profile centers on Retina Specialist (Ophthalmology) Physician. Clinical services aligned with this taxonomy classification.
Can patients visit SPENCER FULLER (MD, MPH) in Reno, Nevada?
For routing, start with Reno, Nevada for SPENCER FULLER (MD, MPH), then verify phone and hours locally.
Can I export SPENCER FULLER (MD, MPH)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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