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MR. CHASE BRANDON FULLERTON PA
NPI 1326391160
Physician Assistant in Salt Lake City, UT

Active since October 17, 2012PECOS EnrolledAccepts Medicare Assignment
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113(801) 662-1000 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Chase Brandon Fullerton Pa NPPES

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

MR. CHASE BRANDON FULLERTON PA (NPI 1326391160) is an individual physician assistant in Salt Lake City, Utah, licensed in Utah (10438332-1206) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS, is affiliated with Portneuf Medical Center, and is a graduate of University Of South Alabama College Of Medicine (2014).

NPPES Registry Identity

NPI1326391160
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. CHASE BRANDON FULLERTONCredential: PA
Location Address100 N MARIO CAPECCHI DRSalt Lake City, UT 84113-1103
Mailing AddressPo Box 30180Salt Lake City, UT 84130-0180
Phone(801) 662-1000
Sole ProprietorNo
Medical School CMSUniversity Of South Alabama College Of MedicineGraduated 2014
Enumeration DateOctober 17, 2012
Last NPPES UpdateJanuary 22, 2026
NPPES CertifiedJanuary 22, 2026
✔ NPI 1326391160 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 UT · 10438332-1206
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.
100 N MARIO CAPECCHI DR, Salt Lake City, UT 84113
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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

Mr. Chase Brandon Fullerton Pa 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 ID7214412477
PECOS Enrollment IDI20260326001494
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

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

Portneuf Medical Center

Acute Care Hospitals · Pocatello, ID
4/5 CMS rating
OwnershipProprietary
CMS Certification Number130028
Location777 Hospital WayPocatello, ID 83201 · Bannock County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84113 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

KEEGAN MARIE RYAN PT, DPT
Physical Therapist
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-4980
IHC HEALTH SERVICES INC
Pediatrics
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
MADELINE ANN THAYER NP
Nurse Practitioner (Family)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-3600
DR. JEFFREY S PRINCE MD
Radiology (Diagnostic Radiology)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 487-0451
MICHELLE PLOUTZ
Pediatrics (Pediatric Cardiology)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
ALICIA DONALDSON APRN
Nurse Practitioner (Pediatrics, Critical Care)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
HANNAH MARIE WINEBAUM MS, OTR/L
Occupational Therapist
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
MARK EDWARD HAMAKER M.D.
Pediatrics (Pediatric Endocrinology)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 587-3922

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 Chase Fullerton's NPI number?

The NPI number for Chase Fullerton is 1326391160. It was assigned to this individual provider in the NPPES registry on October 17, 2012.

Where is Chase Fullerton located?

Chase Fullerton practices at 100 N Mario Capecchi Dr, Salt Lake City, UT 84113. The listed phone number is (801) 662-1000.

What is Chase Fullerton's specialty?

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

Is Chase Fullerton enrolled in Medicare?

Yes. Chase Fullerton 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.

Is Chase Fullerton affiliated with any hospitals?

According to CMS data, Chase Fullerton is affiliated with Portneuf Medical Center.

When was this NPI record last updated?

The NPPES record for Chase Fullerton was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.