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JENNIFER CARROLL FULLER
NPI 1902149933
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Loma Linda, CA

Active since March 27, 2013PECOS EnrolledAccepts Medicare Assignment
85.18/100
CMS Quality Rating
11234 ANDERSON ST # 2586A, LOMA LINDA, CA 92354(909) 558-7884 Get Directions Write a Review

NPPES record last updated: July 10, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 10, 2019, Apr 16, 2018 (2 updates tracked since 2018).

About Jennifer Carroll Fuller NPPES

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

JENNIFER CARROLL FULLER (NPI 1902149933) is an individual otolaryngology/facial plastic surgery provider in Loma Linda, California, licensed in California (A160366) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (2013).

NPPES Registry Identity

NPI1902149933
Entity TypeIndividualFemale
Primary Taxonomy207YX0905X
Provider Legal NameJENNIFER CARROLL FULLER
Location Address11234 ANDERSON ST # 2586ALoma Linda, CA 92354-2804
Mailing Address11234 Anderson St # 2586aLoma Linda, CA 92354-2804 · (909) 558-7884
Phone(909) 558-7884
Sole ProprietorNo
Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 2013
Enumeration DateMarch 27, 2013
Last NPPES UpdateJuly 10, 20192 updates tracked since enumeration
✔ NPI 1902149933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
License✔ Licensed in CA · A160366
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Also ListedOtolaryngologyTaxonomy 207Y00000X · License 63479 (MN)
11234 ANDERSON ST # 2586A, Loma Linda, CA 92354
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer Carroll Fuller 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 ID5991920811
PECOS Enrollment IDI20190903001911
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jennifer Fuller reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Faculty Physicians And Surgeons Of Llusm
Same address
Anatomic Pathology & Clinical Pathology
11234 ANDERSON ST
Loma Linda, CA 92354
  • Reassigned Medicare billing, California enrollment
  • 2,584 clinicians in this Medicare group
NPI 1245605781 (909) 558-6122
Sac Health System
3.7 mi
Federally Qualified Health Center (FQHC)
1454 E 2ND ST
San Bernardino, CA 92408
  • Reassigned Medicare billing, California enrollment
  • 455 clinicians in this Medicare group
NPI 1013935915 (909) 382-7100

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

Areas of Expertise CMS Part B claims 3

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.

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.
57 services30 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.
15 services14 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.
12 services12 patients

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.

85.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.81
Promoting Interoperability82
Improvement Activities40
Cost64.54

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 Jennifer Fuller's NPI number?

The NPI number for Jennifer Fuller is 1902149933. It was assigned to this individual provider in the NPPES registry on March 27, 2013.

Where is Jennifer Fuller located?

Jennifer Fuller practices at 11234 Anderson St # 2586A, Loma Linda, CA 92354. The listed phone number is (909) 558-7884.

What is Jennifer Fuller's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

Is Jennifer Fuller enrolled in Medicare?

Yes. Jennifer 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.

Which organizations bill Medicare for Jennifer Fuller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Fuller reassigns Medicare benefits to 2 organizations: Faculty Physicians And Surgeons Of Llusm (Loma Linda, CA) and Sac Health System (San Bernardino, CA). Each 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 Jennifer 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 Jennifer Fuller was last updated on July 10, 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.