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JOHN D FULK P.A.
NPI 1063419679
Physician Assistant in Normal, IL

Active since June 29, 2005PECOS EnrolledAccepts Medicare Assignment
1302 FRANKLIN AVE, SUITE 4800, NORMAL, IL 61761(309) 454-5900(309) 454-2820 Get Directions Write a Review

NPPES record last updated: April 4, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About John D Fulk P.a. NPPES

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

JOHN D FULK P.A. (NPI 1063419679) is an individual physician assistant in Normal, Illinois, licensed in Illinois (085001126) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1998).

NPPES Registry Identity

NPI1063419679
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJOHN D FULKCredential: P.A.
Location Address1302 FRANKLIN AVE, SUITE 4800Normal, IL 61761-3551
Mailing Address1302 Franklin Ave, Suite 4800Normal, IL 61761-3551 · (309) 454-5900 · Fax (309) 454-2820
Phone(309) 454-5900
Fax(309) 454-2820
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJune 29, 2005
Last NPPES UpdateApril 4, 2019
✔ NPI 1063419679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085001126
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.
1302 FRANKLIN AVE, Normal, IL 61761
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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

John D Fulk P.a. 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 ID8921011198
PECOS Enrollment IDI20060711000450
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 61761 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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.

ASHTON VAN HEEMST
Behavior Technician
1302 FRANKLIN AVE
NORMAL, IL 61761
McLean County (309) 452-0069
DR. THANOM TEMIYASATHIT M.D.
Internal Medicine (Cardiovascular Disease)
1302 FRANKLIN AVE, SUITE 4500
NORMAL, IL 61761
McLean County (309) 828-1166
SUSAN J SVIENTEK M.D.
Obstetrics & Gynecology
1302 FRANKLIN AVE, SUITE 2200
NORMAL, IL 61761
McLean County (309) 888-9900
BETH L TUMILTY DO
Internal Medicine (Cardiovascular Disease)
1302 FRANKLIN AVE, #4500
NORMAL, IL 61761
McLean County (309) 828-1166
MS. MANEESHA T JOSEPH FNP
Nurse Practitioner (Family)
1302 FRANKLIN AVE, SUITE 3400
NORMAL, IL 61761
McLean County (309) 556-8300
OWEN JOHN BEHRENDT
Behavior Technician
1302 FRANKLIN AVE
NORMAL, IL 61761
McLean County (309) 452-0069
ARELY BETANCOURT
Behavior Technician
1302 FRANKLIN AVE
NORMAL, IL 61761
McLean County (309) 452-0069
DR. CHAE CHU M.D.
Internal Medicine (Pulmonary Disease)
1302 FRANKLIN AVE, #2200
NORMAL, IL 61761
McLean County (309) 662-9631

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 John Fulk's NPI number?

The NPI number for John Fulk is 1063419679. It was assigned to this individual provider in the NPPES registry on June 29, 2005.

Where is John Fulk located?

John Fulk practices at 1302 Franklin Ave Suite 4800, Normal, IL 61761. The listed phone number is (309) 454-5900.

What is John Fulk's specialty?

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

Is John Fulk enrolled in Medicare?

Yes. John Fulk 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.

When was this NPI record last updated?

The NPPES record for John Fulk was last updated on April 4, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.