FULERA HEALTHCARE LLC
NPI 1184450157
Clinic/Center in Baltimore, MD
About Fulera Healthcare Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FULERA HEALTHCARE LLC (NPI 1184450157) is a healthcare organization registered as a clinic/center in Baltimore, Maryland and active in the NPI registry since September 2024. The organization lists Iddrisu Tia, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fulera Healthcare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Fulera Healthcare LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Fulera Healthcare LLC's NPI number?
The NPI number for Fulera Healthcare LLC is 1184450157. It was assigned to this organization in the NPPES registry on September 9, 2024.
Where is Fulera Healthcare LLC located?
Fulera Healthcare LLC is located at 4108 Maine Ave, Baltimore, MD 21207. The listed phone number is (301) 793-8201.
What is Fulera Healthcare LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Fulera Healthcare LLC enrolled in Medicare?
Yes. Fulera Healthcare LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fulera Healthcare LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Fulera Healthcare LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Fulera Healthcare LLC was last updated on September 9, 2024. 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.
# Fulera Healthcare Llc · NPI 1184450157
Clinic/Center organization in Baltimore, Maryland. Organization record, active in the CMS NPPES registry since September 9, 2024.
## Identity
- **NPI:** 1184450157 (Entity type: Organization)
- **Enumerated:** September 9, 2024
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Iddrisu Tia, OWNER
## Practice location
- **Address:** 4108 MAINE AVE, Baltimore, MD 21207-7503
- **Phone:** (301) 793-8201
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 9, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1184450157) · Data from the CMS NPPES public registry.