JOHN FULLER (MD) – Emergency Medicine Physician, NPI 1093754574
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JOHN FULLER (MD)
915 N Grand Blvd
Saint Louis, MO 631061621
Phone: (314) 652-4100
Type: Location
10010 KENNERLY RD
SAINT LOUIS, MO 631282106
Phone: (314) 525-1900
Type: Mailing
1836, Lackland Hill Parkway, Ascalon, Maryland Heights, Saint Louis County, Missouri, 63146, United States
ATTN: CREDENTIALING OFFICE
SAINT LOUIS, MO 631463572
Phone: (314) 989-0300
Type: Mailing
SSM Health St. Mary's Hospital: Hospital Building, 6420, Clayton Road, Hi-Pointe, Richmond Heights, Saint Louis County, Missouri, 63117, United States
SAINT LOUIS, MO 631171811
Phone: (314) 768-8000
Fax: (314) 768-8011
Type: Location
1000 E CHERRY ST
TROY, MO 633791513
Phone: (636) 528-8551
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: 2007-03-01
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 |
|---|---|---|---|---|
| I20070301000270 | I | Emergency Medicine | MO | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 54 | 52 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 21 | 21 | $0 |
Insurance plans in this area (ZIP 63106)
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