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DR. KALEB EVAN FULLER DO
NPI 1568086965
Pediatrics - Pediatric Emergency Medicine in Oklahoma City, OK

Active since June 01, 2020PECOS Enrolled
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104(405) 271-4417 Get Directions Write a Review

NPPES record last updated: October 4, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 4, 2024, Jun 1, 2020 (2 updates tracked since 2020).

About Dr. Kaleb Evan Fuller Do NPPES

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

DR. KALEB EVAN FULLER DO (NPI 1568086965) is an individual pediatric emergency medicine provider in Oklahoma City, Oklahoma, licensed in Oklahoma (7338) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2020).

NPPES Registry Identity

NPI1568086965
Entity TypeIndividualMale
Primary Taxonomy2080P0204X
Provider Legal NameDR. KALEB EVAN FULLERCredential: DO
Location Address1200 CHILDRENS AVEOklahoma City, OK 73104-4637
Mailing Address1200 Childrens AveOklahoma City, OK 73104-4637 · (405) 271-4417
Phone(405) 271-4417
Sole ProprietorNo
Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2020
Enumeration DateJune 1, 2020
Last NPPES UpdateOctober 4, 20242 updates tracked since enumeration
NPPES CertifiedOctober 4, 2024
✔ NPI 1568086965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in OK · 7338
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
1200 CHILDRENS AVE, Oklahoma City, OK 73104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kaleb Evan Fuller Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911466156
PECOS Enrollment IDI20260827002658
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 Kaleb Fuller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ou Health Partners, Inc
Same address
Multi-Specialty
1200 CHILDRENS AVE STE 11200
Oklahoma City, OK 73104
  • Reassigned Medicare billing, Oklahoma enrollment
  • 1,795 clinicians in this Medicare group
NPI 1528642642 (405) 271-3932

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.

KRUTI SHAH
Student in an Organized Health Care Education/Training Program
1200 CHILDRENS AVE, SUITE 4D
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-8001
MRS. RACHEL LEIGH CROSS APRN, CPNP-PC
Nurse Practitioner (Pediatrics)
1200 CHILDRENS AVE, SUITE 10000
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4412
KAYLEE MARTIN
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-5437
KRISTEN PUENTE RD, LD
Dietitian, Registered
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4700
ROA MUQBEL
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
DR. CLAIRE ELIZABETH KUNKEL SMITH DO
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
JAY OGLE DO
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
BLAYNE BORDWINE
Pediatrics (Hospice and Palliative Medicine)
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4700

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 Kaleb Fuller's NPI number?

The NPI number for Kaleb Fuller is 1568086965. It was assigned to this individual provider in the NPPES registry on June 1, 2020.

Where is Kaleb Fuller located?

Kaleb Fuller practices at 1200 Childrens Ave, Oklahoma City, OK 73104. The listed phone number is (405) 271-4417.

What is Kaleb Fuller's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Kaleb Fuller enrolled in Medicare?

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

Which organization bills Medicare for Kaleb Fuller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaleb Fuller reassigns Medicare benefits to Ou Health Partners, Inc (Oklahoma City, OK). 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 Kaleb Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kaleb Fuller accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Kaleb Fuller 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 Kaleb Fuller was last updated on October 4, 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.