1. Home
  2. Directory
  3. Massachusetts
  4. Boston
  5. Physician Assistant
  6. NPI Profile

MATTHEW PAUL FULLER PA-C
NPI 1053030759
Physician Assistant in Boston, MA

Active since August 25, 2022PECOS Enrolled
55 FRUIT ST, BOSTON, MA 02114(617) 724-4100(617) 726-7415 Get Directions Write a Review

NPPES record last updated: October 3, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 3, 2023, Aug 25, 2022 (2 updates tracked since 2022).

About Matthew Paul Fuller Pa-c NPPES

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

MATTHEW PAUL FULLER PA-C (NPI 1053030759) is an individual physician assistant in Boston, Massachusetts, licensed in Massachusetts (PA100048) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053030759
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMATTHEW PAUL FULLERCredential: PA-C
Location Address55 FRUIT STBoston, MA 02114-2696
Mailing Address55 Station Lndg Apt 522wMedford, MA 02155-5055
Phone(617) 724-4100
Fax(617) 726-7415
Sole ProprietorNo
Enumeration DateAugust 25, 2022
Last NPPES UpdateOctober 3, 20232 updates tracked since enumeration
NPPES CertifiedOctober 3, 2023
✔ NPI 1053030759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MA · PA100048
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Matthew Paul Fuller Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Fuller's NPI number?

The NPI number for Matthew Fuller is 1053030759. It was assigned to this individual provider in the NPPES registry on August 25, 2022.

Where is Matthew Fuller located?

Matthew Fuller practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 724-4100.

What is Matthew Fuller's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Matthew Fuller enrolled in Medicare?

Yes. Matthew Fuller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Matthew Fuller was last updated on October 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.