RICHARD E FULLER (MD) – Adult Medicine Physician, NPI 1306841002

RICHARD E FULLER (MD) is a healthcare provider. based in Manitowoc, Wisconsin. specializing in PHYSICAL MEDICINE AND REHABILITATION. They hold the professional credentials MD. They hold a License No. 32988-020 (WI). The NPI Number for RICHARD E FULLER (MD) is 1306841002

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
RICHARD E FULLER (MD)
NPI
1306841002
Phone
(920) 320-2591
Address
PO BOX 2290
Enumeration Date
17 June 2005
Last Update Date
11 June 2021

Doctor Profile

Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Secondary Phone
4147361317
Graduation Year
1988 (38 years ago)
PAC ID
9537130539
Group Practice PAC ID
6002141900
Professional Enrollment ID
I20040803001590
Address ID
WI531222338EL15255RDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

256 PHYSICAL MEDICINE AND REHABILITATION in WI

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Provider Addresses for RICHARD E FULLER (MD)

  • PO BOX 2290

    MANITOWOC, WI 542212290

    Phone: (920) 320-2591

    Type: Mailing

  • 4303, Michigan Avenue, Manitowoc Rapids, Manitowoc, Manitowoc County, Wisconsin, 54220, United States

    MANITOWOC, WI 542203066

    Phone: (920) 320-4300

    Fax: (920) 684-5146

    Type: Location

  • 17780 VERSAILLES CT

    BROOKFIELD, WI 530455026

    Phone: (262) 389-1375

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $238.

Total Amount is formed as General ($238) + Research ($0) + Ownership ($0) = $238.

Last reported payment date: 2024-09-10 • Largest payer in this snapshot: Bioventus LLC ($160).

Total Amount

$238

General + Research + Ownership

Payments

10

Total payment records

General Amount

$238

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-08-03

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
I20040803001590IPhysical Medicine And RehabilitationWITBD

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
J1885Injection, ketorolac tromethamine, per 15 mg2,629165$0
77002Fluoroscopic guidance for needle placement1,485172$0
20610Aspiration and/or injection of fluid from large joint1,460169$0
J7321Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose997130$0
97530Therapy procedure using functional activities60279$0
View full utilization report →

Insurance plans in this area (ZIP 54221)

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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: 6002141900View full group profile
NameSpecialtyState
General PracticeWI
Pediatric Medicine, Emergency MedicineMI
General Practice, Preventive MedicineWI

Reviews

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Frequently asked questions

Can I cross-check RICHARD E FULLER (MD) using NPI 1306841002?
NPI 1306841002 belongs to RICHARD E FULLER (MD); compare other details if you need extra assurance.
Is there an active status for RICHARD E FULLER (MD)?
For scheduling context, RICHARD E FULLER (MD) is shown as active in the registry.
What expertise is attributed to RICHARD E FULLER (MD)?
RICHARD E FULLER (MD)'s specialty line reads Adult Medicine Physician. Clinical services aligned with this taxonomy classification.
Is RICHARD E FULLER (MD) located near Manitowoc?
RICHARD E FULLER (MD) currently maps to Manitowoc, Wisconsin in this extract.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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