Frederick Fuller, PA-C
NPI 1154364099 · Medical Physician Assistant · Salt Lake City, UT
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Frederick Fuller, PA-C is a Medical Physician Assistant provider in Salt Lake City, UT (NPI 1154364099).
Provider details
- NPI number
- 1154364099
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 018646 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-06-14
- Last updated
- 2025-01-13
- Certified
- 2025-01-13
Frequently asked questions
- What is Frederick Fuller's NPI number?
- Frederick Fuller's National Provider Identifier (NPI) is 1154364099, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Frederick Fuller's specialty?
- Frederick Fuller is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Frederick Fuller located?
- Frederick Fuller's practice location on file with NPPES is 50 N Medical Dr, Salt Lake City, UT 84132-3004.
- What is Frederick Fuller's phone number?
- The practice phone number listed in the NPPES registry for Frederick Fuller is (801) 581-2292.
- Does Frederick Fuller accept Medicare?
- Frederick Fuller is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Frederick Fuller's NPI active?
- Yes — Frederick Fuller's NPI (1154364099) is active in the NPPES registry as of the last update on 2025-01-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.