CONNOR M FULTZ MD - NPI 1003435132 - Physical Medicine & Rehabilitation in Willow Grove, PA

Q: What is Connor Fultz's NPI number?

The NPI number for Connor Fultz is 1003435132. It was assigned to this individual provider in the NPPES registry on April 9, 2020.

Q: What is Connor Fultz's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.

Q: When was this NPI record last updated?

The NPPES record for Connor Fultz was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Connor M Fultz Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNOR M FULTZ MD (NPI 1003435132) is an individual sports medicine provider in Willow Grove, Pennsylvania, licensed in Pennsylvania (MD486957) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and is a graduate of Drexel University College Of Medicine (2020).

NPPES Registry Identity

NPI1003435132

Entity TypeIndividualMale

Primary Taxonomy2081S0010X

Provider Legal NameCONNOR M FULTZCredential: MD

Location Address2400 MARYLAND RD STE 20Willow Grove, PA 19090-1732

Mailing Address833 Chestnut St Ste 520Philadelphia, PA 19107-4430 · (609) 677-7003

Phone(800) 321-9999

Fax(267) 479-1321

Sole ProprietorNo

Medical School CMSDrexel University College Of MedicineGraduated 2020

Enumeration DateApril 9, 2020

Last NPPES UpdateSeptember 2, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2025

✔ NPI 1003435132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081S0010X

License✔ Licensed in PA · MD486957

Definition

A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.

2400 MARYLAND RD STE 20, Willow Grove, PA 19090

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Connor M Fultz Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022439694

PECOS Enrollment IDI20241118002309

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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