MARY ELIZABETH FULLER (PT) – Physical Therapist, NPI 1295052009

MARY ELIZABETH FULLER (PT) is a healthcare provider. based in Port lavaca, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 1194377 (TX). The NPI Number for MARY ELIZABETH FULLER (PT) is 1295052009

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
MARY ELIZABETH FULLER (PT)
NPI
1295052009
Phone
(361) 552-5400
Address
300 N VIRGINIA ST
Enumeration Date
3 May 2010
Last Update Date
23 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2617820798
Graduation Year
2010 (16 years ago)
PAC ID
4688704596
Group Practice PAC ID
2062577992
Professional Enrollment ID
I20100618000518
Address ID
TX779572569ED522XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:16State licenses:1Digital endpointsOther names

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for MARY ELIZABETH FULLER (PT)

  • 300 N VIRGINIA ST

    PORT LAVACA, TX 779793449

    Phone: (361) 552-5400

    Type: Mailing

  • 522 W MAIN ST

    EDNA, TX 779572569

    Phone: (361) 782-0798

    Fax: (361) 782-0799

    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: 2010-06-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100618000518IPhysical Therapist In Private PracticeTXTBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes82752$0
97530Therapy procedure using functional activities50247$0
97140Therapy procedure using manual technique, each 15 minutes35060$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes24220$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care9222$0
View full utilization report →

Insurance plans in this area (ZIP 77979)

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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: 2062577992View full group profile
NameSpecialtyState
C H I R O P R A C T I CTX

Reviews

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Frequently asked questions

How do I look up MARY ELIZABETH FULLER (PT) by NPI?
Use NPI 1295052009 when you need to reference MARY ELIZABETH FULLER (PT) in forms, claims, or directories.
Does this profile mean MARY ELIZABETH FULLER (PT) is currently active?
Yes — MARY ELIZABETH FULLER (PT) appears active in the national provider directory.
What kind of provider is MARY ELIZABETH FULLER (PT)?
The page reflects Physical Therapist for MARY ELIZABETH FULLER (PT). Clinical services aligned with this taxonomy classification.
Where does public data place MARY ELIZABETH FULLER (PT)?
The snapshot lists Port Lavaca, Texas for MARY ELIZABETH FULLER (PT); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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