PHILIP S FULLER MD
NPI 1760592216
Pediatrics in Southlake, TX
About Philip S Fuller Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHILIP S FULLER MD (NPI 1760592216) is an individual pediatrics provider in Southlake, Texas, licensed in Texas (E0922) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Philip S Fuller Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Philip Fuller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Cook Childrens Physician Network
- 1,186 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 76092 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Philip Fuller's NPI number?
The NPI number for Philip Fuller is 1760592216. It was assigned to this individual provider in the NPPES registry on August 30, 2006.
Where is Philip Fuller located?
Philip Fuller practices at 2727 E Southlake Blvd, Southlake, TX 76092. The listed phone number is (682) 885-6000.
What is Philip Fuller's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Philip Fuller enrolled in Medicare?
Yes. Philip Fuller is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Philip Fuller's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Philip Fuller reassigns Medicare benefits to Cook Children's Physician Network (Fort Worth, TX). The 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 Philip Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Philip Fuller was last updated on November 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.
# Philip S Fuller, MD · NPI 1760592216
Pediatrics physician in Southlake, Texas. Individual provider, active in the CMS NPPES registry since August 30, 2006.
## Identity
- **NPI:** 1760592216 (Entity type: Individual)
- **Enumerated:** August 30, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** E0922 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 2727 E SOUTHLAKE BLVD, Southlake, TX 76092-6613
- **Phone:** (682) 885-6000 · **Fax:** (682) 885-6050
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Cook Children's Physician Network (NPI 1083472062, Fort Worth, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 18, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1760592216) · Data from the CMS NPPES public registry.