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DR. DONALD RAY FULSOM M.D.
NPI 1679568794
Psychiatry & Neurology - Addiction Psychiatry in Tyler, TX

Active since September 14, 2005Opted out of Medicare · through Oct 1, 2027
306 E HOUSTON ST, TYLER, TX 75702(903) 593-6550(903) 593-6554 Get Directions Write a Review

NPPES record last updated: May 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Donald Ray Fulsom M.d. NPPES

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

DR. DONALD RAY FULSOM M.D. (NPI 1679568794) is an individual addiction psychiatry provider in Tyler, Texas, licensed in Texas (L6047) and active in the NPI registry since September 2005. He has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1679568794
Entity TypeIndividualMale
Primary Taxonomy2084P0802X
Provider Legal NameDR. DONALD RAY FULSOMCredential: M.D.
Location Address306 E HOUSTON STTyler, TX 75702-8218
Mailing Address306 E Houston StTyler, TX 75702-8218 · (903) 593-6550 · Fax (903) 593-6554
Phone(903) 593-6550
Fax(903) 593-6554
Sole ProprietorYes
Enumeration DateSeptember 14, 2005
Last NPPES UpdateMay 14, 2025
NPPES CertifiedMay 14, 2025
✔ NPI 1679568794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Addiction PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0802X
License✔ Licensed in TX · L6047
Definition
Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X · License L6047 (TX)
306 E HOUSTON ST, Tyler, TX 75702
Open in Google Maps ↗

Other Identifiers 1

Medicaid158042501TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Donald Ray Fulsom M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2015 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2015
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM PAUL ANDREWS PHD
Psychologist (Clinical)
306 E HOUSTON ST
TYLER, TX 75702
Smith County (903) 581-2085

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 Donald Fulsom's NPI number?

The NPI number for Donald Fulsom is 1679568794. It was assigned to this individual provider in the NPPES registry on September 14, 2005.

Where is Donald Fulsom located?

Donald Fulsom practices at 306 E Houston St, Tyler, TX 75702. The listed phone number is (903) 593-6550.

What is Donald Fulsom's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Psychiatry, with taxonomy code 2084P0802X.

Is Donald Fulsom enrolled in Medicare?

No. Donald Fulsom has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Donald Fulsom accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Providence Health Plan and UnitedHealthcare list Donald Fulsom 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 Donald Fulsom was last updated on May 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.