MATTHEW FULTON
NPI 1255561775
Surgery in Cincinnati, OH

Q: What is Matthew Fulton's NPI number?

The NPI number for Matthew Fulton is 1255561775. It was assigned to this individual provider in the NPPES registry on July 17, 2009.

Q: What is Matthew Fulton's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Fulton was last updated on June 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since July 17, 2009PECOS EnrolledAccepts Medicare Assignment

98.3/100

CMS Quality Rating

3301 MERCY HEALTH BLVD, SUITE 525, CINCINNATI, OH 45211(513) 841-7700(513) 841-7701 Get Directions Write a Review

NPPES record last updated: June 19, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Matthew Fulton NPPES

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

MATTHEW FULTON (NPI 1255561775) is an individual surgery provider in Cincinnati, Ohio, licensed in Michigan (4301094972) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Mercy Health - Fairfield Hospital, and is a graduate of University Of Cincinnati College Of Medicine (2009).

NPPES Registry Identity

NPI1255561775

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameMATTHEW FULTON

Location Address3301 MERCY HEALTH BLVD, SUITE 525Cincinnati, OH 45211-1118

Mailing Address2000 Joseph E Sanker BlvdCincinnati, OH 45212-1979 · (513) 841-7400 · Fax (513) 841-7402

Phone(513) 841-7700

Fax(513) 841-7701

Sole ProprietorNo

Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 2009

Enumeration DateJuly 17, 2009

Last NPPES UpdateJune 19, 2015

✔ NPI 1255561775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in MI · 4301094972

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedUrologyTaxonomy 208800000X · License 35125792 (OH)

3301 MERCY HEALTH BLVD, Cincinnati, OH 45211

Open in Google Maps ↗

Other Identifiers 3

Medicare PIN9284399OH

Medicare NSC1114950006OH

OtherCC2433OH · Medicare Rr

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Matthew Fulton 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 ID3678705969

PECOS Enrollment IDI20150714001294

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 Reassignment

Medicare enrollment records show Matthew Fulton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tri State Urologic Services Psc Inc

0.2 mi

Urology

3301 MERCY HEALTH BLVD, SUITE 525
Cincinnati, OH 45211

Reassigned Medicare billing, Ohio enrollment
68 clinicians in this Medicare group

NPI 1396938312 (513) 841-7700

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

Areas of Expertise CMS Part B claims 32

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

623 services439 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

562 services403 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

171 services38 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

160 services141 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

143 services112 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

125 services107 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

108 services101 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

101 services101 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

97 services32 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

70 services69 patients

Simple change of bladder tube 51705

A simple change of bladder tube involves replacing your current urinary drainage tube with a new one. This is done to maintain hygiene and prevent infections. It's a straightforward process, usually causing minimal discomfort, and helps ensure your body can properly dispose of waste fluids.

69 services25 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

49 services49 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies 51728

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

32 services31 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

30 services30 patients

Bacterial colony count, urine 87086

A bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).

30 services28 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

29 services28 patients

Psa (prostate specific antigen) measurement, free 84154

A PSA measurement, free, is a simple blood test that checks for a specific protein produced by your body. Higher levels may indicate a health concern that needs further investigation. This test is often used to monitor overall wellness.

29 services29 patients

Analysis for detection of tumor marker 86316

An analysis for detection of tumor markers is a type of test that identifies specific substances, known as markers, in the body. These markers can indicate the presence of certain types of abnormal growths. This test aids in early detection and monitoring of these growths.

29 services29 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

29 services28 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

27 services21 patients

Blood creatinine level 82565

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

25 services25 patients

Urea nitrogen level to assess kidney function, quantitative 84520

The urea nitrogen level test is a routine blood test that checks the amount of urea nitrogen in your blood to evaluate how well your kidneys are working. If the levels are higher than normal, it may indicate that your kidneys are not functioning properly.

22 services22 patients

Bacterial urine culture 87088

A bacterial urine culture is a laboratory test that checks for bacteria in your urine. It helps identify the type of bacteria causing an infection, enabling the selection of the most effective treatment. The test involves collecting a urine sample in a sterile container.

20 services19 patients

Testosterone (hormone) level, total 84403

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

17 services16 patients

Bacterial culture for aerobic isolates 87077

A bacterial culture for aerobic isolates is a lab test that helps identify bacteria that thrive in oxygen-rich environments. A sample from the suspected infection site is collected, then placed in a special medium that promotes bacterial growth. After a set period, the lab identifies any bacteria present, aiding in accurate diagnosis and treatment.

15 services13 patients

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution 87186

This process checks how well certain drugs, like antibiotics, can fight against infections. It involves mixing the drug with a microbe (like bacteria or a virus) in a lab. By observing how the microbe reacts, it helps determine the best drug to treat your infection.

15 services13 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

14 services13 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

13 services13 patients

Exam with injections of chemical for destruction of bladder using an endoscope 52287

This procedure involves the use of a thin, flexible tube with a light (endoscope) for internal examination. A chemical is then injected to help eliminate specific issues in the bladder. It's a standard and safe process.

12 services12 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

12 services12 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

12 services11 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Mercy Health - Fairfield Hospital

Acute Care Hospitals · Fairfield, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360056

Location3000 Mack RoadFairfield, OH 45014 · Butler County

Emergency services Birthing friendly

Good Samaritan Hospital

Acute Care Hospitals · Cincinnati, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360134

Location375 Dixmyth AvenueCincinnati, OH 45220 · Hamilton County

Emergency services Birthing friendly

Christ Hospital

Acute Care Hospitals · Cincinnati, OH

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360163

Location2139 Auburn AvenueCincinnati, OH 45219 · Hamilton County

Emergency services Birthing friendly

Bethesda North

Acute Care Hospitals · Cincinnati, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number360179

Location10500 Montgomery RoadCincinnati, OH 45242 · Hamilton County

Emergency services Birthing friendly

Mercy Health - West Hospital

Acute Care Hospitals · Cincinnati, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360234

Location3300 Mercy Health BlvdCincinnati, OH 45211 · Hamilton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45211 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

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.

98.3/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4338

DME-Orthotic Devices · category DF000N

2 suppliers126 claims135 services$10.85 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

5 suppliers14 claims23 services$9.08 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

4 suppliers27 claims36 services$5.24 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. WEI GIBLER M.D.

Obstetrics & Gynecology

3301 MERCY HEALTH BLVD, SUITE 215
CINCINNATI, OH 45211

Hamilton County (513) 481-5100

DR. AMBROSE ANTHONY PUTTMANN M.D.

Obstetrics & Gynecology

3301 MERCY HEALTH BLVD, SUITE 215
CINCINNATI, OH 45211

Hamilton County (513) 481-5100

DR. DENNIS J WIWI M.D.

Obstetrics & Gynecology

3301 MERCY HEALTH BLVD, SUITE 215
CINCINNATI, OH 45211

Hamilton County (513) 481-5100

MARC J PLISKIN DO

Urology

3301 MERCY HEALTH BLVD, SUITE 525
CINCINNATI, OH 45211

Hamilton County (513) 841-7700

JENNIFER JORDAN RN

Registered Nurse (Oncology)

3301 MERCY HEALTH BLVD
CINCINNATI, OH 45211

Hamilton County (513) 751-2273

DR. LISA M POMERLEAU MD

Internal Medicine

3301 MERCY HEALTH BLVD, STE. 340
CINCINNATI, OH 45211

Hamilton County (513) 981-5922

DR. SHAWN JAY YANG M.D.

Orthopaedic Surgery

3301 MERCY HEALTH BLVD, STE 450
CINCINNATI, OH 45211

Hamilton County (513) 981-6784

JEFFREY STRIET MD

Internal Medicine (Cardiovascular Disease)

3301 MERCY HEALTH BLVD, SUITE 125
CINCINNATI, OH 45211

Hamilton County (513) 215-9200

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 Matthew Fulton's NPI number?

The NPI number for Matthew Fulton is 1255561775. It was assigned to this individual provider in the NPPES registry on July 17, 2009.

Where is Matthew Fulton located?

Matthew Fulton practices at 3301 Mercy Health Blvd Suite 525, Cincinnati, OH 45211. The listed phone number is (513) 841-7700.

What is Matthew Fulton's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Matthew Fulton enrolled in Medicare?

Yes. Matthew Fulton 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 organization bills Medicare for Matthew Fulton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Fulton reassigns Medicare benefits to Tri State Urologic Services Psc Inc (Cincinnati, OH). The 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 Matthew Fulton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Matthew Fulton accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 4 other insurers list Matthew Fulton 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 Matthew Fulton affiliated with any hospitals?

According to CMS data, Matthew Fulton is affiliated with Mercy Health - Fairfield Hospital, Good Samaritan Hospital, Christ Hospital, Bethesda North and Mercy Health - West Hospital.

When was this NPI record last updated?

The NPPES record for Matthew Fulton was last updated on June 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.