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JESSICA FULLMER MD
NPI 1578199592
Family Medicine in Provo, UT

Active since March 21, 2020PECOS EnrolledAccepts Medicare Assignment
95.7/100
CMS Quality Rating

NPPES record last updated: July 14, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 14, 2023, Mar 1, 2023, Mar 21, 2020 (3 updates tracked since 2020).

About Jessica Fullmer Md NPPES

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

JESSICA FULLMER MD (NPI 1578199592) is an individual family medicine provider in Provo, Utah, licensed in Utah (5602710-1205) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of University Of Utah School Of Medicine (2020).

NPPES Registry Identity

NPI1578199592
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameJESSICA FULLMERCredential: MD
Location Address475 W 940 NProvo, UT 84604-3301
Mailing Address475 W 940 NProvo, UT 84604-3301 · (801) 357-7686
Phone(801) 357-7686
Sole ProprietorNo
Medical School CMSUniversity Of Utah School Of MedicineGraduated 2020
Enumeration DateMarch 21, 2020
Last NPPES UpdateJuly 14, 20233 updates tracked since enumeration
NPPES CertifiedJuly 14, 2023
✔ NPI 1578199592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 5602710-1205
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
475 W 940 N, Provo, UT 84604
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.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

Jessica Fullmer 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 ID4385041268
PECOS Enrollment IDI20210920001677
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 Reassignments

2

Medicare enrollment records show Jessica Fullmer reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ihc Health Services Inc
0.9 mi
Internal Medicine
380 W 1230 N, STE 602
Provo, UT 84604
  • Reassigned Medicare billing, Utah enrollment
  • 3,691 clinicians in this Medicare group
NPI 1578079059 (801) 442-1853
University Of Utah Community Physicians Group
3.0 mi
Family Medicine
145 W UNIVERSITY PKWY
Orem, UT 84058
  • Reassigned Medicare billing, Utah enrollment
  • 295 clinicians in this Medicare group
NPI 1427452135 (801) 234-8600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
229 services106 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
92 services58 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
37 services37 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
13 services11 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

95.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality92.19
Promoting Interoperability100
Improvement Activities40

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.

MR. TYLER JASON FIELDSTED DO
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7926
KARLY GARDNER DO
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
TYSON DEKORSE M.D.
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7940
SAMANTHA BENGTZEN DERZON MD
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7940
EASTON E WEAVER
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
MARK CONLEY DO
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
DR. JASON ROBERT HERMAN D.O.
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
MARIANGELA SANTIAGO PARRA DO
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930

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 Jessica Fullmer's NPI number?

The NPI number for Jessica Fullmer is 1578199592. It was assigned to this individual provider in the NPPES registry on March 21, 2020.

Where is Jessica Fullmer located?

Jessica Fullmer practices at 475 W 940 N, Provo, UT 84604. The listed phone number is (801) 357-7686.

What is Jessica Fullmer's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jessica Fullmer enrolled in Medicare?

Yes. Jessica Fullmer 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 Jessica Fullmer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Fullmer reassigns Medicare benefits to 2 organizations: Ihc Health Services Inc (Provo, UT) and University Of Utah Community Physicians Group (Orem, UT). 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 Jessica Fullmer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Fullmer accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Jessica Fullmer 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 Jessica Fullmer affiliated with any hospitals?

According to CMS data, Jessica Fullmer is affiliated with University Of Utah Hospitals And Clinics.

When was this NPI record last updated?

The NPPES record for Jessica Fullmer was last updated on July 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.