DR. COLIN WYATT FULLER (M.D.) – Pediatric Otolaryngology Physician, NPI 1922413343
Pediatric Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
113 OTOLARYNGOLOGY in OK
Provider Addresses for DR. COLIN WYATT FULLER (M.D.)
800 STANTON L YOUNG BLVD # 1400
OKLAHOMA CITY, OK 731045018
Phone: (405) 271-5504
Type: Location
1 CHILDRENS WAY # 653
LITTLE ROCK, AR 722023500
Phone: (501) 364-1100
Type: Mailing
1120 FIFTEENTH ST, BP-4109
AUGUSTA, GA 30912
Phone: (706) 721-4307
Type: Location
800 STANTON L YOUNG BLVD
OKLAHOMA CITY, OK 731045018
Phone: (405) 271-5504
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $128.
Total Amount is formed as General ($128) + Research ($0) + Ownership ($0) = $128.
Last reported payment date: 2024-06-13 • Largest payer in this snapshot: AXOGEN ($128).
Total Amount
$128
General + Research + Ownership
Payments
1
Total payment records
General Amount
$128
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AXOGEN | $128 |
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: 2021-08-25
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20210825001481 | I | Otolaryngology | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73104)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| R H E U M A T O L O G Y | OK | |
| Orthopedic Surgery, Hand Surgery | OK | |
| A N E S T H E S I O L O G Y | OK | |
| Hospitalist, Internal Medicine | OK | |
| Pediatric Medicine, Hematology/Oncology | VA | |
| Pulmonary Disease, Internal Medicine | OK | |
| Clinical Psychologist | OK | |
| Emergency Medicine | OK | |
| Critical Care (Intensivists), Pediatric Medicine | OK | |
| Endocrinology, Pediatric Medicine | OK |
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.