DR. GREGORY W FULLER D.O.
NPI 1174569107
Emergency Medicine in Jackson, MI
About Dr. Gregory W Fuller D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. GREGORY W FULLER D.O. (NPI 1174569107) is an individual emergency medicine provider in Jackson, Michigan, licensed in Michigan (5101012543) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Gregory W Fuller D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Gregory Fuller reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lansing, MI 48910
- Reassigned Medicare billing, Michigan enrollment
- 295 clinicians in this Medicare group
Lansing, MI 48912
- Reassigned Medicare billing, Michigan enrollment
- 112 clinicians in this Medicare group
Portland, MI 48875
- Reassigned Medicare billing, Michigan enrollment
- 317 clinicians in this Medicare group
Detroit, MI 48236
- Reassigned Medicare billing, Michigan enrollment
- Medicare enrollment name: Emergency Department Physicians PC
- 237 clinicians in this Medicare group
Detroit, MI 48236
- Reassigned Medicare billing, Michigan enrollment
- Medicare enrollment name: Observation Emergency Physicians PC
- 158 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Gregory Fuller's NPI number?
The NPI number for Gregory Fuller is 1174569107. It was assigned to this individual provider in the NPPES registry on June 20, 2006.
Where is Gregory Fuller located?
Gregory Fuller practices at 1006 Airport Rd, Jackson, MI 49202. The listed phone number is (517) 784-6663.
What is Gregory Fuller's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Gregory Fuller enrolled in Medicare?
Yes. Gregory Fuller is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Gregory Fuller's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Fuller reassigns Medicare benefits to 5 organizations: Degara App, PLLC (Lansing, MI), Vituity - Michigan Em PC (Lansing, MI), Sparrow Ionia Hospital (Portland, MI), Emergency Department Physicians, P.C. (Detroit, MI) and Observation Emergency Physicians, P.C. (Detroit, MI). 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 Gregory Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Gregory Fuller accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Health Maintenance Organization of Florida and Priority Health list Gregory Fuller 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.
When was this NPI record last updated?
The NPPES record for Gregory Fuller was last updated on September 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Gregory W Fuller, D.O. · NPI 1174569107
Emergency Medicine physician in Jackson, Michigan. Individual provider, active in the CMS NPPES registry since June 20, 2006.
## Identity
- **NPI:** 1174569107 (Entity type: Individual)
- **Enumerated:** June 20, 2006
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 5101012543 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1006 AIRPORT RD, Jackson, MI 49202-1851
- **Phone:** (517) 784-6663 · **Fax:** (517) 787-7976
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Degara App, PLLC (NPI 1265976971, Lansing, MI); Vituity - Michigan Em PC (NPI 1144892332, Lansing, MI); Sparrow Ionia Hospital (NPI 1295801108, Portland, MI); Emergency Department Physicians, P.C. (NPI 1225083595, Detroit, MI); Observation Emergency Physicians, P.C. (NPI 1497920524, Detroit, MI) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 23, 2021
- **Other identifiers:** Other GF012543 (MI); Medicaid 114545400 (MI)
---
Source: [NPI Profile](https://npiprofile.com/npi/1174569107) · Data from the CMS NPPES public registry.