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DR. COREY BRANDON FULLER MD
NPI 1053637694
Orthopaedic Surgery - Sports Medicine in Loma Linda, CA

Active since April 07, 2010PECOS EnrolledAccepts Medicare Assignment
85.18/100
CMS Quality Rating
25455 BARTON RD STE 102B, LOMA LINDA, CA 92354(909) 558-6444(909) 558-6118 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 18, 2026, May 30, 2023, Dec 3, 2021 and 2 more (5 updates tracked since 2019).

About Dr. Corey Brandon Fuller Md NPPES

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

DR. COREY BRANDON FULLER MD (NPI 1053637694) is an individual sports medicine provider in Loma Linda, California, licensed in California (A118405) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, maintains a secondary practice location in Portland, and is a graduate of Loma Linda University School Of Medicine (2010).

NPPES Registry Identity

NPI1053637694
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameDR. COREY BRANDON FULLERCredential: MD
Location Address25455 BARTON RD STE 102BLoma Linda, CA 92354-3139
Mailing Address11406 Loma Linda Dr Ste 226Loma Linda, CA 92354-3711 · (909) 558-6644 · Fax (909) 558-6118
Phone(909) 558-6444
Fax(909) 558-6118
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2010
Enumeration DateApril 7, 2010
Last NPPES UpdateMarch 18, 20265 updates tracked since enumeration
NPPES CertifiedMarch 18, 2026
✔ NPI 1053637694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in CA · A118405
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License A118405 (CA), MD229227 (OR)
25455 BARTON RD STE 102B, Loma Linda, CA 92354
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Secondary Practice Location 1

Location 1450 N Graham StPortland, OR 97227-1682 · Phone (503) 413-4488

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

Dr. Corey Brandon Fuller 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 ID4385950930
PECOS Enrollment IDI20150827002930
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Corey Fuller reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Faculty Physicians And Surgeons Of Llusm
Same address
Orthopaedic Surgery
25455 BARTON RD
Loma Linda, CA 92354
  • Reassigned Medicare billing, California enrollment
  • 2,584 clinicians in this Medicare group
NPI 1275582918 (909) 558-3111
Sac Health System
4.0 mi
Federally Qualified Health Center (FQHC)
1454 E 2ND ST
San Bernardino, CA 92408
  • Reassigned Medicare billing, California enrollment
  • 455 clinicians in this Medicare group
NPI 1013935915 (909) 382-7100
Legacy Clinics LLC
828 mi
Rural Health
36860 INDUSTRIAL WAY
Sandy, OR 97055
  • Reassigned Medicare billing, Oregon enrollment
  • 1,248 clinicians in this Medicare group
NPI 1730472192 (503) 826-0206

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.81
Promoting Interoperability82
Improvement Activities40
Cost64.54

Other Providers at the Same Location NPPES 5

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

JOHN KING
Orthopaedic Surgery (Hand Surgery)
25455 BARTON RD STE 102B
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2808
DR. THOMAS BURGDORFF M.D.
Orthopaedic Surgery
25455 BARTON RD STE 102B
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2808
JASON Y CHEN MD
Orthopaedic Surgery
25455 BARTON RD STE 102B
LOMA LINDA, CA 92354
San Bernardino County (909) 558-6444
DR. MICHAEL H WRIGHT MD
Orthopaedic Surgery
25455 BARTON RD STE 102B
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2808
ODYSSEY JASMIN CONTRERAS ATC
Physician Assistant
25455 BARTON RD STE 102B
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2808

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 Corey Fuller's NPI number?

The NPI number for Corey Fuller is 1053637694. It was assigned to this individual provider in the NPPES registry on April 7, 2010.

Where is Corey Fuller located?

Corey Fuller practices at 25455 Barton Rd Ste 102B, Loma Linda, CA 92354. The listed phone number is (909) 558-6444.

What is Corey Fuller's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Corey Fuller enrolled in Medicare?

Yes. Corey Fuller is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Corey Fuller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Corey Fuller reassigns Medicare benefits to 3 organizations: Faculty Physicians And Surgeons Of Llusm (Loma Linda, CA), Sac Health System (San Bernardino, CA) and Legacy Clinics LLC (Sandy, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Corey Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Corey Fuller was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.