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DR. CLARK BEEMAN FULLER M.D.
NPI 1790890341
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Los Angeles, CA

Active since August 21, 2006PECOS EnrolledAccepts Medicare Assignment
8635 W 3RD ST, SUITE 975W, LOS ANGELES, CA 90048(310) 652-0530(310) 652-9936 Get Directions Write a Review

NPPES record last updated: April 19, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Clark Beeman Fuller M.d. NPPES

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

DR. CLARK BEEMAN FULLER M.D. (NPI 1790890341) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Los Angeles, California, licensed in California (G76647) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Creighton University School Of Medicine (1987).

NPPES Registry Identity

NPI1790890341
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameDR. CLARK BEEMAN FULLERCredential: M.D.
Location Address8635 W 3RD ST, SUITE 975WLos Angeles, CA 90048-6101
Mailing Address8635 W 3rd St, Suite 975wLos Angeles, CA 90048-6101 · (310) 652-0530 · Fax (310) 652-9936
Phone(310) 652-0530
Fax(310) 652-9936
Sole ProprietorNo
Medical School CMSCreighton University School Of MedicineGraduated 1987
Enumeration DateAugust 21, 2006
Last NPPES UpdateApril 19, 2018
✔ NPI 1790890341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in CA · G76647
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Also ListedSpecialistTaxonomy 174400000X · License G76647 (CA)
8635 W 3RD ST, Los Angeles, CA 90048
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Other Identifiers 1

MedicaidGR0091070CA

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

Dr. Clark Beeman Fuller 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 ID7911186721
PECOS Enrollment IDI20110126000413
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 8

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.

Removal of lymph nodes of chest cavity using an endoscope 32674
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to access and remove lymph nodes in the chest cavity. It's a minimally invasive method, which can help in diagnosing or treating certain conditions.
74 services74 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.
45 services36 patients
Exam of lung with removal of lung lobe using an endoscope 32663
This is a procedure where an endoscope, a thin tube with a light and camera, is used to examine the lung and remove a lobe if necessary. It's less invasive than traditional surgery, resulting in shorter recovery time.
39 services39 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
38 services38 patients
Initial removal of wedge of lung tissue using an endoscope 32666
This procedure involves the use of an endoscope, a thin tube with a light and camera, to view and remove a small wedge of lung tissue. It's performed to diagnose or treat lung conditions. The process is minimally invasive, reducing recovery time.
27 services27 patients
Exam of chest with biopsy of lymph node using an endoscope 39402
This procedure involves using a thin, flexible tube called an endoscope to examine the chest and extract a small sample from a lymph node. The sample is then studied to diagnose or rule out certain conditions. It's a safe procedure performed under sedation.
21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90048 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
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier18 claims18 services$12.97 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers31 claims31 services$62.72 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$32.07 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

I-HSUAN LIN DPT
Physical Therapist
8635 W 3RD ST, SUITE 465W
LOS ANGELES, CA 90048
Los Angeles County (310) 657-8591
JAY W MARKS MD
Internal Medicine (Gastroenterology)
8635 W 3RD ST, SUITE #880
LOS ANGELES, CA 90048
Los Angeles County (323) 469-4499
JEFFREY FREDRICK CAREN M.D.
Specialist
8635 W 3RD ST, 890W
LOS ANGELES, CA 90048
Los Angeles County (310) 659-0714
HART C.M. COHEN
Specialist
8635 W 3RD ST, 450W
LOS ANGELES, CA 90048
Los Angeles County (310) 652-5954
JAY J STEIN M.D.
Urology
8635 W 3RD ST, SUITE 460W
LOS ANGELES, CA 90048
Los Angeles County (310) 652-8810
MR. DUDLEY S DANOFF MD
Urology
8635 W 3RD ST, SUITE 1 WEST
LOS ANGELES, CA 90048
Los Angeles County (310) 854-9898
RODRIGO F ALBAN M.D.
Surgery (Surgical Critical Care)
8635 W 3RD ST, SUITE 650W
LOS ANGELES, CA 90048
Los Angeles County (310) 423-8513
COR MEDICAL GROUP, INC
Specialist
8635 W 3RD ST, SUITE 890W
LOS ANGELES, CA 90048
Los Angeles County (310) 659-0714

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 Clark Fuller's NPI number?

The NPI number for Clark Fuller is 1790890341. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is Clark Fuller located?

Clark Fuller practices at 8635 W 3rd St Suite 975W, Los Angeles, CA 90048. The listed phone number is (310) 652-0530.

What is Clark Fuller's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Clark Fuller enrolled in Medicare?

Yes. Clark Fuller 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.

When was this NPI record last updated?

The NPPES record for Clark Fuller was last updated on April 19, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.