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BRENNA SULLIVAN FULLERTON M.D.
NPI 1366741720
Surgery - Pediatric Surgery in Orlando, FL

Active since March 23, 2011PECOS EnrolledAccepts Medicare Assignment
1720 S ORANGE AVE STE 500, ORLANDO, FL 32806(140) 754-0100(407) 540-1011 Get Directions Write a Review

NPPES record last updated: August 20, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 20, 2021, Jul 24, 2018 (2 updates tracked since 2018).

About Brenna Sullivan Fullerton M.d. NPPES

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

BRENNA SULLIVAN FULLERTON M.D. (NPI 1366741720) is an individual pediatric surgery provider in Orlando, Florida, licensed in Florida (ME150199) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1366741720
Entity TypeIndividualFemale
Primary Taxonomy2086S0120X
Provider Legal NameBRENNA SULLIVAN FULLERTONCredential: M.D.
Location Address1720 S ORANGE AVE STE 500Orlando, FL 32806-2967
Mailing Address1720 S Orange Ave Ste 500Orlando, FL 32806-2967 · (140) 754-0100 · Fax (407) 540-1011
Phone(140) 754-0100
Fax(407) 540-1011
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateMarch 23, 2011
Last NPPES UpdateAugust 20, 20212 updates tracked since enumeration
NPPES CertifiedAugust 20, 2021
✔ NPI 1366741720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in FL · ME150199
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Also ListedSurgeryTaxonomy 208600000X · License 259770 (MA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1720 S ORANGE AVE STE 500, Orlando, FL 32806
Open in Google Maps ↗

Other Names 1

Former Name (1)Brenna Elizabeth Sullivan Md

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, AvMed, Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

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

Brenna Sullivan Fullerton M.d. 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 ID143623488
PECOS Enrollment IDI20210726000365
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.

Other Providers at the Same Location NPPES 5

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

DEVINN SHAVONNE GOREY
Physician Assistant (Surgical)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000
DR. DONALD PLUMLEY MD
Surgery (Pediatric Surgery)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000
MICHELLE DOMINGUEZ
Physician Assistant (Surgical)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1616
GABRIEL JOSE RAMOS-GONZALEZ M.D.
Surgery (Pediatric Surgery)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000
EMILY ROSE ULLOA PA
Physician Assistant (Surgical)
1720 S ORANGE AVE STE 500
ORLANDO, FL 32806
Orange County (407) 540-1000

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 Brenna Fullerton's NPI number?

The NPI number for Brenna Fullerton is 1366741720. It was assigned to this individual provider in the NPPES registry on March 23, 2011. The provider is also known as Brenna Elizabeth Sullivan MD.

Where is Brenna Fullerton located?

Brenna Fullerton practices at 1720 S Orange Ave Ste 500, Orlando, FL 32806. The listed phone number is (140) 754-0100.

What is Brenna Fullerton's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Brenna Fullerton enrolled in Medicare?

Yes. Brenna 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.

What insurance does Brenna Fullerton accept?

Health plans from AmeriHealth Caritas Next, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Brenna Fullerton 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 Brenna Fullerton was last updated on August 20, 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.