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GREGG S FULMER MD
NPI 1396781944
Hospitalist in Bellefontaine, OH

Active since June 21, 2006PECOS EnrolledAccepts Medicare Assignment
83.82/100
CMS Quality Rating
205 PALMER AVE., BELLEFONTAINE, OH 43311(937) 592-4015 Get Directions Write a Review

NPPES record last updated: May 18, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Gregg S Fulmer Md NPPES

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

GREGG S FULMER MD (NPI 1396781944) is an individual hospitalist provider in Bellefontaine, Ohio, licensed in Ohio (35081568) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Riverside Methodist Hospital, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1396781944
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameGREGG S FULMERCredential: MD
Location Address205 PALMER AVE.Bellefontaine, OH 43311-2281
Mailing Address205 E Palmer RdBellefontaine, OH 43311-2281 · (937) 593-0245 · Fax (937) 592-8633
Phone(937) 592-4015
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateJune 21, 2006
Last NPPES UpdateMay 18, 2022
NPPES CertifiedMay 18, 2022
✔ NPI 1396781944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in OH · 35081568
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 35.081568 (OH)
205 PALMER AVE., Bellefontaine, OH 43311
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Other Identifiers 8

Other87726Uhc
Other7755544Aetna
Other341407259037Medical Mutual
OtherFU7340041Tricare
Other000000026809Anthem
Other341407259Nationwide
Medicaid2369057OH
Other341407259Cigna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MedMutual.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

Gregg S Fulmer Md 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 ID5395716070
PECOS Enrollment IDI20040804001949
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.

Areas of Expertise CMS Part B claims 11

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
414 services199 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
335 services162 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
316 services136 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
195 services180 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
135 services127 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
88 services88 patients

Hospital Affiliations CMS Care Compare 4

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

Riverside Methodist Hospital

Acute Care Hospitals · Columbus, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360006
Location3535 Olentangy River RdColumbus, OH 43214 · Franklin County
Emergency services Birthing friendly

Lima Memorial Health System

Acute Care Hospitals · Lima, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360009
Location1001 Bellefontaine AvenueLima, OH 45804 · Allen County
Emergency services Birthing friendly

Ohio State University State Health System

Acute Care Hospitals · Columbus, OH
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number360085
Location410 West 10th AvenueColumbus, OH 43210 · Franklin County
Emergency services Birthing friendly

Mary Rutan Hospital

Acute Care Hospitals · Bellefontaine, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360197
Location205 Palmer AvenueBellefontaine, OH 43311 · Logan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43311 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

83.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality25.21
Promoting Interoperability100
Improvement Activities40
Cost92.1

Reported Quality Measures

Advance Care Plan
62%1,198 patients3/55-star benchmark: 100%
Coronary Artery Disease (CAD): Antiplatelet Therapy
64%92 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
47%2,062 patients1/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
95%1,131 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 14

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

Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6203
DME-Medical/Surgical Supplies · category DA023N
2 suppliers12 claims434 services$3.27 avg. paid by Medicare
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446
DME-Medical/Surgical Supplies · category DA023N
2 suppliers13 claims1,614 services$0.37 avg. paid by Medicare
Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
2 suppliers11 claims11 services$64.09 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers15 claims15 services$75.85 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
5 suppliers106 claims106 services$22.38 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier24 claims24 services$920.55 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Gregg Fulmer's NPI number?

The NPI number for Gregg Fulmer is 1396781944. It was assigned to this individual provider in the NPPES registry on June 21, 2006.

Where is Gregg Fulmer located?

Gregg Fulmer practices at 205 Palmer Ave., Bellefontaine, OH 43311. The listed phone number is (937) 592-4015.

What is Gregg Fulmer's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Gregg Fulmer enrolled in Medicare?

Yes. Gregg Fulmer 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 Gregg Fulmer accept?

Health plans from MedMutual list Gregg Fulmer 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 Gregg Fulmer affiliated with any hospitals?

According to CMS data, Gregg Fulmer is affiliated with Riverside Methodist Hospital, Lima Memorial Health System, Ohio State University State Health System and Mary Rutan Hospital.

When was this NPI record last updated?

The NPPES record for Gregg Fulmer was last updated on May 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.