SHELBY FULLEN CAA
NPI 1023492816
Anesthesiologist Assistant in Columbus, OH

Q: What is Shelby Fullen's NPI number?

The NPI number for Shelby Fullen is 1023492816. It was assigned to this individual provider in the NPPES registry on July 13, 2015.

Q: What is Shelby Fullen's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Shelby Fullen was last updated on April 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since July 13, 2015Accepts Medicare Assignment

410 W 10TH AVE FL 1, COLUMBUS, OH 43210(614) 293-8487(614) 293-8153 Get Directions Write a Review

NPPES record last updated: April 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Shelby Fullen Caa NPPES

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

SHELBY FULLEN CAA (NPI 1023492816) is an individual anesthesiologist assistant in Columbus, Ohio, licensed in Ohio (67.000543) and active in the NPI registry since July 2015. She is affiliated with Ohio State University State Health System, maintains a secondary practice location in Washington, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1023492816

Entity TypeIndividualFemale

Primary Taxonomy367H00000X

Provider Legal NameSHELBY FULLENCredential: CAA

Location Address410 W 10TH AVE FL 1Columbus, OH 43210-1240

Mailing Address700 Ackerman Rd Ste 2120Columbus, OH 43202-1559 · (614) 293-8487

Phone(614) 293-8487

Fax(614) 293-8153

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJuly 13, 2015

Last NPPES UpdateApril 25, 2025

NPPES CertifiedApril 25, 2025

✔ NPI 1023492816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

Licenses✔ Licensed in OH · 67.000543✔ Licensed in DC · AA000058

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

410 W 10TH AVE FL 1, Columbus, OH 43210

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Secondary Practice Location 1

Location 1110 Irving St NWWashington, DC 20010-3017 · Phone (202) 877-7000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shelby Fullen Caa 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 ID446569461

PECOS Enrollment IDI20250506000399

Medicare Billing Reassignments

Medicare enrollment records show Shelby Fullen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Osu Observation Medicine, LLC

Same address

Anesthesiology

410 W 10TH AVE
Columbus, OH 43210

Reassigned Medicare billing, Ohio enrollment
551 clinicians in this Medicare group

NPI 1407095052 (614) 293-8487

Washington Hospital Center Corp

329 mi

Nurse Practitioner

110 IRVING ST NW, MEDICAL AFFAIRS
Washington, DC 20010

Reassigned Medicare billing, District of Columbia enrollment
264 clinicians in this Medicare group

NPI 1376627406 (202) 877-5284

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on upper abdomen 00790

Anesthesia for an upper abdomen procedure involves using medications to help you feel no pain during the operation. It can be general, where you're unconscious, or regional, where just the abdomen area is numbed. It ensures comfort and stillness, aiding a successful procedure.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ohio State University State Health System

Acute Care Hospitals · Columbus, OH

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number360085

Location410 West 10th AvenueColumbus, OH 43210 · Franklin County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

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

THOMAS E. GRAUL D.O.

Anesthesiology