JAMES K FULLERTON M.D.
NPI 1760575229
Surgery in Springfield, IL

Q: What is James Fullerton's NPI number?

The NPI number for James Fullerton is 1760575229. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Q: What is James Fullerton's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for James Fullerton was last updated on May 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 02, 2006PECOS EnrolledAccepts Medicare Assignment

95.01/100

CMS Quality Rating

900 N 1ST ST, SPRINGFIELD, IL 62702(217) 528-7541(217) 744-2537 Get Directions Write a Review

NPPES record last updated: May 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About James K Fullerton M.d. NPPES

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

JAMES K FULLERTON M.D. (NPI 1760575229) is an individual surgery provider in Springfield, Illinois, licensed in Illinois (036-110732) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Medical College Of Wisconsin (1999).

NPPES Registry Identity

NPI1760575229

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameJAMES K FULLERTONCredential: M.D.

Location Address900 N 1ST STSpringfield, IL 62702-3749

Mailing Address1025 S 6th StSpringfield, IL 62703-2403 · (217) 528-7541 · Fax (217) 528-8962

Phone(217) 528-7541

Fax(217) 744-2537

Sole ProprietorNo

Medical School CMSMedical College Of WisconsinGraduated 1999

Enumeration DateOctober 2, 2006

Last NPPES UpdateMay 22, 2020

NPPES CertifiedMay 22, 2020

✔ NPI 1760575229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in IL · 036-110732

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

900 N 1ST ST, Springfield, IL 62702

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Other Identifiers 1

Medicaid036110732IL

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

James K Fullerton M.d. 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 ID9537147905

PECOS Enrollment IDI20040712000881

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 15

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

139 services44 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.

58 services58 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.

54 services53 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

39 services36 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

35 services35 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services23 patients

Removal of gallbladder with x-ray study of bile ducts using an endoscope 47563

This procedure, known as an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible camera (endoscope) to examine your bile ducts. If gallstones are found, your gallbladder may be removed in a separate procedure. This helps prevent future complications.

26 services26 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

25 services22 patients

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.

24 services24 patients

Repair of groin hernia using an endoscope 49650

This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.

17 services17 patients

Repair of hernia of muscle at esophagus and stomach using an endoscope 43281

This procedure fixes a hernia, an area where your stomach and esophagus muscles have weakened. Using an endoscope, a thin tube with a camera, the doctor can see and repair the hernia without large incisions, promoting quicker recovery.

15 services15 patients

Incision of pancreatic outlet using a flexible endoscope 43262

This procedure involves a small cut in the outlet of the pancreas using a flexible tube with a camera, called an endoscope. It helps doctors diagnose and treat conditions affecting the pancreas, enhancing patient comfort and recovery.

14 services14 patients

Insertion of central venous tube with port (5 years or older) 36561

A central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.

13 services12 patients

Fluoroscopic guidance for insertion or removal of central vein access device 77001

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

13 services12 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140148

Location701 N First StSpringfield, IL 62702 · Sangamon County

Emergency services Birthing friendly

Taylorville Memorial Hospital

Critical Access Hospitals · Taylorville, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number141339

Location201 East Pleasant StreetTaylorville, IL 62568 · Christian County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

95.01/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.02

Promoting Interoperability

100

Improvement Activities

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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.

AMY N MANN APRN

Nurse Practitioner (Gerontology)