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TY FULLMER DO
NPI 1679136758
Emergency Medicine in Clinton Township, MI

Active since April 15, 2019PECOS EnrolledAccepts Medicare Assignment
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038(586) 263-2300 Get Directions Write a Review

NPPES record last updated: May 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2022, Mar 20, 2021, Apr 15, 2019 (3 updates tracked since 2019).

About Ty Fullmer Do NPPES

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

TY FULLMER DO (NPI 1679136758) is an individual emergency medicine provider in Clinton Township, Michigan, licensed in Utah (12811005-1204) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Mckay-dee Hospital, and maintains a secondary practice location in Ogden.

NPPES Registry Identity

NPI1679136758
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameTY FULLMERCredential: DO
Location Address15855 19 MILE RDClinton Township, MI 48038-3504
Mailing Address15855 19 Mile RdClinton Township, MI 48038-3504
Phone(586) 263-2300
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateApril 15, 2019
Last NPPES UpdateMay 19, 20223 updates tracked since enumeration
NPPES CertifiedMay 19, 2022
✔ NPI 1679136758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in UT · 12811005-1204
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
15855 19 MILE RD, Clinton Township, MI 48038
Open in Google Maps ↗

Secondary Practice Location 1

Location 14401 Harrison BlvdOgden, UT 84403-3195 · Phone (801) 387-7000

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

Ty Fullmer Do 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 ID3476888637
PECOS Enrollment IDI20220913004135
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 6

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
146 services145 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
105 services97 patients
Electrocardiogram (ecg) 1 to 3 leads with review by physician only 93042
An Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. 1 to 3 leads or sensors are placed on your body to capture this data. A physician then reviews the results to evaluate your heart's health.
98 services97 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
31 services31 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
22 services21 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.
12 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Mckay-Dee Hospital

Acute Care Hospitals · Ogden, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460004
Location4401 Harrison BoulevardOgden, UT 84403 · Weber County
Emergency services Birthing friendly

Intermountain Health Layton Hospital

Acute Care Hospitals · Layton, UT
OwnershipVoluntary non-profit - Private
CMS Certification Number460061
Location201 West Layton ParkwayLayton, UT 84041 · Davis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48038 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

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.

MS. LEEANN WICKENS P.A.
Physician Assistant
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (586) 203-1940
CYNTHIA GEE D.O.
Emergency Medicine
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (701) 340-2053
SARAH E NELSON
Nurse Practitioner (Adult Health)
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (313) 623-7602
MS. KARA NICOLE SZCZOMAK PA-C
Physician Assistant
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 263-2601
EMILY SOPEL
Occupational Therapist
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (586) 263-2300
ANTONIO MACERI MD
Student in an Organized Health Care Education/Training Program
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 263-2300
HENRY FORD MACOMB HOSPITAL CORPORATION
General Acute Care Hospital
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (568) 263-2705
JEFFREY A BERG CRNA
Nurse Anesthetist, Certified Registered
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (586) 263-2370

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 Ty Fullmer's NPI number?

The NPI number for Ty Fullmer is 1679136758. It was assigned to this individual provider in the NPPES registry on April 15, 2019.

Where is Ty Fullmer located?

Ty Fullmer practices at 15855 19 Mile Rd, Clinton Township, MI 48038. The listed phone number is (586) 263-2300.

What is Ty Fullmer's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Ty Fullmer enrolled in Medicare?

Yes. Ty 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.

Is Ty Fullmer affiliated with any hospitals?

According to CMS data, Ty Fullmer is affiliated with Mckay-Dee Hospital and Intermountain Health Layton Hospital.

When was this NPI record last updated?

The NPPES record for Ty Fullmer was last updated on May 19, 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.