FULLERTON SURGERY CENTER INC – Ambulatory Surgical Clinic/Center, NPI 1285675678

FULLERTON SURGERY CENTER INC is a healthcare provider. based in Chicago, Illinois. specializing in Ambulatory Surgical Clinic/Center. The organization holds a License No. 042618689 (IL). The NPI Number for FULLERTON SURGERY CENTER INC is 1285675678

Main info

Organization
Name
FULLERTON SURGERY CENTER INC
NPI
1285675678
Phone
(773) 237-2900
Address
4849 W FULLERTON AVE
Authorized Official
NASER RUSTOM OWNER/MEDICAL DIRECTOR M.D.
Enumeration Date
9 June 2006
Last Update Date
6 February 2018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for FULLERTON SURGERY CENTER INC

  • 4839-4849, West Fullerton Avenue, Beat 2522, Chicago, Jefferson Township, Cook County, Illinois, 60639, United States

    CHICAGO, IL 606392503

    Phone: (773) 237-2900

    Fax: (773) 622-0769

    Mailing address matches the actual address.

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: 2006-06-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-06-30 (708 days ago).

Enrollment records

1

Earliest due date

2024-06-30

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
O20060619000118OAmbulatory Surgical CenterIL2024-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope2121$0
45380Biopsy of large bowel using a flexible endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 60639)

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Reviews

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Frequently asked questions

What is the standard ID for FULLERTON SURGERY CENTER INC in the U.S.?
In the U.S., FULLERTON SURGERY CENTER INC is identified by NPI 1285675678.
Does the public listing show FULLERTON SURGERY CENTER INC as active?
FULLERTON SURGERY CENTER INC's NPI record reflects an active status in NPPES.
What does the directory say FULLERTON SURGERY CENTER INC does?
Insurance directories may phrase it differently, but here FULLERTON SURGERY CENTER INC maps to Ambulatory Surgical Clinic/Center. Clinical services aligned with this taxonomy classification.
Which community is linked to FULLERTON SURGERY CENTER INC?
FULLERTON SURGERY CENTER INC shows a connection to Chicago, Illinois in registry-derived data.
Why is information missing for FULLERTON SURGERY CENTER INC?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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