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DR. JACOB I FULKERSON M.D.
NPI 1093026858
Emergency Medicine in Louisville, KY

Active since June 27, 2010PECOS EnrolledAccepts Medicare Assignment
73.19/100
CMS Quality Rating
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202(502) 852-5689 Get Directions Write a Review

NPPES record last updated: March 3, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 3, 2021, Jul 16, 2018 (2 updates tracked since 2018).

About Dr. Jacob I Fulkerson M.d. NPPES

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

DR. JACOB I FULKERSON M.D. (NPI 1093026858) is an individual emergency medicine provider in Louisville, Kentucky, licensed in Kentucky (46144) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Legacy Meridian Park Medical Center, and maintains a secondary practice location in La Grange.

NPPES Registry Identity

NPI1093026858
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. JACOB I FULKERSONCredential: M.D.
Location Address200 ABRAHAM FLEXNER WAYLouisville, KY 40202
Mailing AddressPo Box 909Louisville, KY 40201-0909
Phone(502) 852-5689
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2010
Enumeration DateJune 27, 2010
Last NPPES UpdateMarch 3, 20212 updates tracked since enumeration
NPPES CertifiedMarch 3, 2021
✔ NPI 1093026858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in KY · 46144✔ Licensed in SC · LL32875
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
200 ABRAHAM FLEXNER WAY, Louisville, KY 40202
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Secondary Practice Location 1

Location 11025 New Moody LnLA Grange, KY 40031-9154 · Phone (502) 222-5388 · Fax (502) 225-5610

Other Identifiers 1

Medicaid7100247730KY

Accepted Insurance

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

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

Dr. Jacob I Fulkerson M.d. 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 ID4688813710
PECOS Enrollment IDI20250327003849
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.

Hospital Affiliations CMS Care Compare 2

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

Legacy Meridian Park Medical Center

Acute Care Hospitals · Tualatin, OR
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380089
Location19300 SW 65th AvenueTualatin, OR 97062 · Washington County
Emergency services Birthing friendly

Providence Seaside Hospital

Critical Access Hospitals · Seaside, OR
OwnershipVoluntary non-profit - Church
CMS Certification Number381303
Location725 S Wahanna RoadSeaside, OR 97138 · Clatsop County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

73.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.74
Promoting Interoperability100
Improvement Activities40
Cost51.91

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.

MAR MILBURN
Pharmacist
200 ABRAHAM FLEXNER WAY, ADMINISTRATION
LOUISVILLE, KY 40202
Jefferson County (502) 210-4210
ERIC HO CHUN CHEUNG MD
Internal Medicine
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202
Jefferson County (502) 587-4267
DR. CYNTHIA H HART MD
Radiology (Diagnostic Radiology)
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202
Jefferson County (502) 587-4231
JESSICA ANN BANET BLAKE FNP-C
Nurse Practitioner
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202
Jefferson County (502) 367-3360
LOUISVILLE KIDNEY CARE LLC
Internal Medicine (Nephrology)
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202
Jefferson County (502) 587-4011
UOFL HEALTH-LOUISVILLE INC
Pharmacy (Community/Retail Pharmacy)
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202
Jefferson County (615) 268-1380
MRS. KELLY GOSHORN A.P.R.N.
Nurse Practitioner (Family)
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
EMMA ROSE GANSHIRT FOX
Emergency Medicine
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689

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 Jacob Fulkerson's NPI number?

The NPI number for Jacob Fulkerson is 1093026858. It was assigned to this individual provider in the NPPES registry on June 27, 2010.

Where is Jacob Fulkerson located?

Jacob Fulkerson practices at 200 Abraham Flexner Way, Louisville, KY 40202. The listed phone number is (502) 852-5689.

What is Jacob Fulkerson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Jacob Fulkerson enrolled in Medicare?

Yes. Jacob Fulkerson 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.

What insurance does Jacob Fulkerson accept?

Health plans from CareSource list Jacob Fulkerson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jacob Fulkerson affiliated with any hospitals?

According to CMS data, Jacob Fulkerson is affiliated with Legacy Meridian Park Medical Center and Providence Seaside Hospital.

When was this NPI record last updated?

The NPPES record for Jacob Fulkerson was last updated on March 3, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.