KYLIE FULLER MD INC
NPI 1891473872
Obstetrics & Gynecology in Pomona, CA

Q: What is Kylie Fuller MD Inc's NPI number?

The NPI number for Kylie Fuller MD Inc is 1891473872. It was assigned to this organization in the NPPES registry on July 10, 2023.

Q: What is Kylie Fuller MD Inc's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since July 10, 2023

250 W BONITA AVE STE 100, POMONA, CA 91767(412) 327-1596 Get Directions Write a Review

NPPES record last updated: July 7, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 7, 2026, Nov 8, 2023, Jul 10, 2023 (3 updates tracked since 2023).

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About Kylie Fuller Md Inc NPPES

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

KYLIE FULLER MD INC (NPI 1891473872) is a healthcare organization registered as an obstetrics & gynecology in Pomona, California and active in the NPI registry since July 2023. The organization maintains a secondary practice location in Pomona and lists Kylie A Fuller, Owner, as its authorized official.

NPPES Registry Identity

NPI1891473872

Entity TypeOrganization

Primary Taxonomy207V00000X

Legal Business NameKYLIE FULLER MD INC

Location Address250 W BONITA AVE STE 100Pomona, CA 91767-1863

Mailing Address250 W Bonita Ave Ste 100Pomona, CA 91767-1863

Phone(412) 327-1596

Organization SubpartNo

Authorized OfficialKylie A FullerOwner · (909) 392-2002

Enumeration DateJuly 10, 2023

Last NPPES UpdateJuly 7, 20263 updates tracked since enumeration

NPPES CertifiedJuly 7, 2026

✔ NPI 1891473872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

250 W BONITA AVE STE 100, Pomona, CA 91767

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Secondary Practice Location 1

Location 1210 W Bonita Ave Ste 2Pomona, CA 91767-1865 · Phone (909) 392-2002

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kylie Fuller Md Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Kylie Fuller MD Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Theophilus Mason, FNP

Nurse Practitioner

NPI 1205580701

250 W BONITA AVE STE 100
Pomona, CA 91767

(909) 392-2002

✔ PECOSSame address

Kylie Fuller, MD

Obstetrics/Gynecology

NPI 1598224875

250 BON AIR RD
Greenbrae, CA 94904

(415) 925-7591

✔ PECOS✔ Accepts Medicare377 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kylie Fuller MD Inc's NPI number?

The NPI number for Kylie Fuller MD Inc is 1891473872. It was assigned to this organization in the NPPES registry on July 10, 2023.

Where is Kylie Fuller MD Inc located?

Kylie Fuller MD Inc is located at 250 W Bonita Ave Ste 100, Pomona, CA 91767. The listed phone number is (412) 327-1596.

What is Kylie Fuller MD Inc's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kylie Fuller MD Inc enrolled in Medicare?

Yes. Kylie Fuller MD Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kylie Fuller MD Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Kylie Fuller MD Inc, in Nurse Practitioner and Obstetrics/Gynecology. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kylie Fuller MD Inc was last updated on July 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.