DR. CHARLES BERRY FULLENWIDER (M.D.) – Neurological Surgery Physician, NPI 1447245063
Neurological Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
89 NEUROSURGERY in OK
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Provider Addresses for DR. CHARLES BERRY FULLENWIDER (M.D.)
333, South 38th Street, Muskogee, Muskogee County, Oklahoma, 74401, United States
SUITE F
MUSKOGEE, OK 744014937
Phone: (918) 682-8087
Fax: (918) 682-6449
Type: Mailing
4318 W OKMULGEE ST
MUSKOGEE, OK 744014648
Phone: (918) 683-1238
Fax: (918) 683-1239
Type: Location
6600 S YALE AVE STE 1400
TULSA, OK 741363331
Phone:
Type: Mailing
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: 2010-11-02
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 |
|---|---|---|---|---|
| I20101102001163 | I | Neurosurgery | OK | 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 |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 45 | 45 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 41 | 32 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 28 | 22 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 19 | 19 | $0 |
Insurance plans in this area (ZIP 74401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| Physician Assistant | OK | |
| Physician Assistant | OK | |
| Nurse Practitioner | OK | |
| - | OK | |
| - | OK | |
| Nurse Practitioner | OK | |
| P O D I A T R Y | OK | |
| Pediatric Medicine | OK | |
| - | OK |
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