CHARLES O FULLENWIDER M.D.
NPI 1417299298
Anesthesiology - Pain Medicine in San Diego, CA
About Charles O Fullenwider M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHARLES O FULLENWIDER M.D. (NPI 1417299298) is an individual pain medicine provider in San Diego, California, licensed in Oklahoma (31587) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Oklahoma College Of Medicine (2013).
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Locations 2
Accepted 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
Charles O Fullenwider 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.
Medicare Billing Reassignments
3Medicare enrollment records show Charles Fullenwider reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Diego, CA 92108
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Oklahoma City, OK 73134
- Reassigned Medicare billing, Oklahoma enrollment
- 9 clinicians in this Medicare group
Addison, TX 75001
- Reassigned Medicare billing, Oklahoma enrollment
- 84 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
SAN DIEGO, CA 92134
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 Charles Fullenwider's NPI number?
The NPI number for Charles Fullenwider is 1417299298. It was assigned to this individual provider in the NPPES registry on March 20, 2013.
Where is Charles Fullenwider located?
Charles Fullenwider practices at 34800 Bob Wilson Dr, San Diego, CA 92134. The listed phone number is (619) 532-8937.
What is Charles Fullenwider's specialty?
The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.
Is Charles Fullenwider enrolled in Medicare?
Yes. Charles Fullenwider 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 organizations bill Medicare for Charles Fullenwider's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Charles Fullenwider reassigns Medicare benefits to 3 organizations: Southern California Permanente Medical Group (San Diego, CA), Oklahoma Pain Management PLLC (Oklahoma City, OK) and Orthomed Staffing LLC (Addison, TX). Each 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 Charles Fullenwider's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Charles Fullenwider accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Charles Fullenwider 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 Charles Fullenwider was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Charles O Fullenwider, M.D. · NPI 1417299298
Pain Medicine physician in San Diego, California. Individual provider, active in the CMS NPPES registry since March 20, 2013.
## Identity
- **NPI:** 1417299298 (Entity type: Individual)
- **Enumerated:** March 20, 2013
- **Primary specialty:** Anesthesiology - Pain Medicine · taxonomy 207LP2900X
- **State license:** 31587 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 34800 BOB WILSON DR, San Diego, CA 92134-1098
- **Phone:** (619) 532-8937
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Southern California Permanente Medical Group (NPI 1023425972, San Diego, CA); Oklahoma Pain Management PLLC (NPI 1679760912, Oklahoma City, OK); Orthomed Staffing LLC (NPI 1225514276, Addison, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Oklahoma College Of Medicine, class of 2013
## Record status
- **NPPES last updated:** May 27, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1417299298) · Data from the CMS NPPES public registry.