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GARY FULKERSON P.A.
NPI 1730165176
Physician Assistant in Prescott Valley, AZ

Active since December 19, 2005PECOS Enrolled
3001 N MAIN ST STE 1C, PRESCOTT VALLEY, AZ 86314(928) 458-5470(928) 458-5979 Get Directions Write a Review

NPPES record last updated: March 27, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Gary Fulkerson P.a. NPPES

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

GARY FULKERSON P.A. (NPI 1730165176) is an individual physician assistant in Prescott Valley, Arizona, licensed in Arizona (7347) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730165176
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameGARY FULKERSONCredential: P.A.
Location Address3001 N MAIN ST STE 1CPrescott Valley, AZ 86314-1215
Mailing Address3001 N Main St Ste 1cPrescott Valley, AZ 86314-1215 · (928) 458-5470 · Fax (928) 458-5979
Phone(928) 458-5470
Fax(928) 458-5979
Sole ProprietorNo
Enumeration DateDecember 19, 2005
Last NPPES UpdateMarch 27, 2019
✔ NPI 1730165176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in AZ · 7347
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA1673 (NV), 103161-1206 (UT)
3001 N MAIN ST STE 1C, Prescott Valley, AZ 86314
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Other Identifiers 1

Other061506129UT · Tin

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Fulkerson P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86314 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
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.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%1,521 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
65%222 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%159 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
61%1,170 patients3/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
99%1,170 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%1,170 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
5%1,170 patients
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
Patients nutrition: 1% · 713 patients
Patients physicalActivity: 0% · 713 patients
99%713 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

MEAGAN ELIZABETH COOMER NP
Pediatrics
3001 N MAIN ST STE 1C
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 458-5470

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 Gary Fulkerson's NPI number?

The NPI number for Gary Fulkerson is 1730165176. It was assigned to this individual provider in the NPPES registry on December 19, 2005.

Where is Gary Fulkerson located?

Gary Fulkerson practices at 3001 N Main St Ste 1C, Prescott Valley, AZ 86314. The listed phone number is (928) 458-5470.

What is Gary Fulkerson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Gary Fulkerson enrolled in Medicare?

Yes. Gary Fulkerson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gary Fulkerson was last updated on March 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.