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LISA L FULLER M.D.
NPI 1366567398
Preventive Medicine - Occupational Medicine in Mesa, AZ

Active since March 20, 2007PECOS Enrolled
4315 E MAIN ST, MESA, AZ 85205(480) 870-7500(480) 906-2173 Get Directions Write a Review

NPPES record last updated: August 8, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Lisa L Fuller M.d. NPPES

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

LISA L FULLER M.D. (NPI 1366567398) is an individual occupational medicine provider in Mesa, Arizona, licensed in Arizona (33576) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Mesa.

NPPES Registry Identity

NPI1366567398
Entity TypeIndividualFemale
Primary Taxonomy2083X0100X
Provider Legal NameLISA L FULLERCredential: M.D.
Location Address4315 E MAIN STMesa, AZ 85205-8605
Mailing Address102 Woodmont Blvd Ste 600Nashville, TN 37205-5250
Phone(480) 870-7500
Fax(480) 906-2173
Sole ProprietorNo
Enumeration DateMarch 20, 2007
Last NPPES UpdateAugust 8, 2024
NPPES CertifiedAugust 8, 2024
✔ NPI 1366567398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreventive Medicine · Occupational MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083X0100X
License✔ Licensed in AZ · 33576
Definition
Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability.
4315 E MAIN ST, Mesa, AZ 85205
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Secondary Practice Location 1

Location 11720 W Southern Ave, Suite B1-B6Mesa, AZ 85202-4834 · Phone (615) 778-4066

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa L Fuller M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Lisa Fuller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Archwell Health Professional Services Of Arizona, LLC
Same address
Internal Medicine
4315 E MAIN ST
Mesa, AZ 85205
  • Reassigned Medicare billing, Arizona enrollment
  • 110 clinicians in this Medicare group
NPI 1558026880 (480) 870-7500

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 85205 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NASRIN JAZAYERI N.P.
Nurse Practitioner (Family)
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 870-7500
CHANCE ALLAN JUDD PA-C
Physician Assistant
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 870-7500
DR. JAY MITCHELL PHARM.D
Pharmacist
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 654-0260
SPENCER CASEY SCOTT DO
Family Medicine
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 870-7500
ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC
Internal Medicine
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 870-7500
DR. ANNA SOKOLOWSKI M.D.
Family Medicine
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 870-7500
MRS. WENDY L DODT RPH
Pharmacist
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 654-0260
DR. IRAM H KHAN M.D.
Internal Medicine
4315 E MAIN ST
MESA, AZ 85205
Maricopa County (480) 870-7500

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 Lisa Fuller's NPI number?

The NPI number for Lisa Fuller is 1366567398. It was assigned to this individual provider in the NPPES registry on March 20, 2007.

Where is Lisa Fuller located?

Lisa Fuller practices at 4315 E Main St, Mesa, AZ 85205. The listed phone number is (480) 870-7500.

What is Lisa Fuller's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Occupational Medicine, with taxonomy code 2083X0100X.

Is Lisa Fuller enrolled in Medicare?

Yes. Lisa Fuller is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Fuller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Fuller reassigns Medicare benefits to Archwell Health Professional Services Of Arizona, LLC (Mesa, AZ). 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 Lisa Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lisa Fuller was last updated on August 8, 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.