JILL C FULLER (MD) – Family Medicine Physician, NPI 1871576744
Family Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
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Provider Addresses for JILL C FULLER (MD)
955, Powell Avenue Southwest, Renton, King County, Washington, 98057, United States
RENTON, WA 980572908
Phone: (425) 277-1311
Type: Mailing
King County Public Health, 33431, 13th Place South, Kitts Corner, Federal Way, King County, Washington, 98003, United States
FEDERAL WAY, WA 980036357
Phone: (253) 874-7634
Fax: (253) 874-7635
Type: Location
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: 2005-12-22
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 |
|---|---|---|---|---|
| I20051222000632 | I | Family Practice | WA | 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 |
|---|---|---|---|---|
| 83036 | Hemoglobin a1c level | 24 | 15 | $0 |
Insurance plans in this area (ZIP 98057)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA | |
| Family Practice | DC | |
| Pediatric Medicine | TN | |
| - | WA | |
| Family Practice | ID | |
| Family Practice | WA | |
| Family Practice | WA | |
| General Practice | WA | |
| Nurse Practitioner | WA | |
| Family Practice | AZ |
Reviews
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