DANIEL BOSTON FULLER – Acute Care Nurse Practitioner, NPI 1629404264

DANIEL BOSTON FULLER is a healthcare provider. based in Chesapeake, Virginia. specializing in Acute Care Nurse Practitioner. They hold a License No. 0024171194 (VA). The NPI Number for DANIEL BOSTON FULLER is 1629404264

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
DANIEL BOSTON FULLER
NPI
1629404264
Phone
(828) 230-4102
Address
340 COMPAZ RD
Enumeration Date
14 September 2013
Last Update Date
2 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7578896890
Graduation Year
2013 (13 years ago)
PAC ID
8628208402
Group Practice PAC ID
3173955671
Professional Enrollment ID
I20140221000846
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:12State licenses:1Digital endpointsOther names

Provider Addresses for DANIEL BOSTON FULLER

  • 340 COMPAZ RD

    CHESAPEAKE, VA 233211602

    Phone: (828) 230-4102

    Type: Mailing

  • 620 JOHN PAUL JONES CIR

    PORTSMOUTH, VA 237082111

    Phone: (828) 230-4102

    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: 2014-02-21

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
I20140221000846INurse PractitionerVATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23321)

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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: 3173955671View full group profile
NameSpecialtyState
Radiation OncologyTX
-VA
Pulmonary Disease, Critical Care (Intensivists)WV
Cardiovascular Disease (Cardiology), Thoracic SurgeryMI
Hospitalist, Internal MedicineVA
Interventional Cardiology, Cardiovascular Disease (Cardiology)VA
-VA
-VA
-VA
-VA

Reviews

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Frequently asked questions

What is the registry number for DANIEL BOSTON FULLER?
The registry entry for DANIEL BOSTON FULLER shows NPI 1629404264.
Should I treat DANIEL BOSTON FULLER as an active provider?
Patients and plans typically see DANIEL BOSTON FULLER as active in the national extract.
What services align with DANIEL BOSTON FULLER's listing?
DANIEL BOSTON FULLER's public classification highlights Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit DANIEL BOSTON FULLER in Chesapeake, Virginia?
For routing, start with Chesapeake, Virginia for DANIEL BOSTON FULLER, then verify phone and hours locally.
Why is information missing for DANIEL BOSTON FULLER?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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