LARRY CHAD FULLER STUDENT
NPI 1912360421
Radiology - Diagnostic Radiology in Gainesville, FL

Active since April 01, 2016PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1600 SW ARCHER RD, GAINESVILLE, FL 32610(352) 265-0291 Get Directions Write a Review

NPPES record last updated: October 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 20, 2025, Jul 9, 2021, Jun 11, 2021 and 2 more (5 updates tracked since 2016).

About Larry Chad Fuller Student NPPES

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

LARRY CHAD FULLER STUDENT (NPI 1912360421) is an individual diagnostic radiology provider in Gainesville, Florida, licensed in Florida (OS17722) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Ocala, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1912360421
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameLARRY CHAD FULLERCredential: STUDENT
Location Address1600 SW ARCHER RDGainesville, FL 32610-2360
Mailing AddressPo Box 100374Gainesville, FL 32610-0374 · (352) 265-0291
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 1, 2016
Last NPPES UpdateOctober 1, 20255 updates tracked since enumeration
NPPES CertifiedOctober 1, 2025
NPI 1912360421 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Licenses Licensed in FL · OS17722 Licensed in VA · 0102209072 Licensed in GA · 1322733
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
1600 SW ARCHER RD, Gainesville, FL 32610

Other Identifiers 1

Medicaid110846200FL

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

Larry Chad Fuller Student 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 ID4284990698
PECOS Enrollment IDI20210610000694, I20220611000321, I20251031002687
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 81

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
9,855 services106 patients
Injection, gadobenate dimeglumine (multihance), per ml A9577
Gadobenate Dimeglumine (MultiHance) is a contrast agent used in MRI scans. Injected into your body, it helps to enhance the quality of the images captured during the scan. It aids in highlighting differences between normal and abnormal tissues, making diagnosis easier and more accurate.
1,285 services75 patients
X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
738 services689 patients
Ct scan head or brain without contrast 70450
A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.
342 services328 patients
Screening mammography 77067
Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.
165 services165 patients
Screening 3d breast mammography 77063
Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.
164 services164 patients

Hospital Affiliations CMS Care Compare 5

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

Adventhealth Ocala

Acute Care Hospitals · Ocala, FL
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100062
Location1500 SW 1st AveOcala, FL 34474 · Marion County
Emergency services Birthing friendly

Marion Communtiy Hospital

Acute Care Hospitals · Ocala, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100212
Location1431 SW 1st AveOcala, FL 34471 · Marion County
Emergency services

Tampa General Hospital Crystal River

Acute Care Hospitals · Crystal River, FL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100249
Location6201 N Suncoast BlvdCrystal River, FL 34428 · Citrus County

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number110029
Location743 Spring StreetGainesville, GA 30501 · Hall County
Emergency services Birthing friendly

Sentara Northern Virginia Medical Center

Acute Care Hospitals · Woodbridge, VA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490113
Location2300 Opitz BoulevardWoodbridge, VA 22191 · Prince William County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32610 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

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.

Pediatrics
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Surgery
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Dentist (Prosthodontics)
1600 SW ARCHER RD, D4-4
GAINESVILLE, FL 32610
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Ophthalmology
1600 SW ARCHER RD, BOX 100284
GAINESVILLE, FL 32610
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610

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 Larry Fuller's NPI number?

The NPI number for Larry Fuller is 1912360421. It was assigned to this individual provider in the NPPES registry on April 1, 2016.

Where is Larry Fuller located?

Larry Fuller practices at 1600 SW Archer Rd, Gainesville, FL 32610. The listed phone number is (352) 265-0291.

What is Larry Fuller's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Larry Fuller enrolled in Medicare?

Yes. Larry 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.

Is Larry Fuller affiliated with any hospitals?

According to CMS data, Larry Fuller is affiliated with Adventhealth Ocala, Marion Communtiy Hospital, Tampa General Hospital Crystal River, Northeast Georgia Medical Center, Inc and Sentara Northern Virginia Medical Center.

When was this NPI record last updated?

The NPPES record for Larry Fuller was last updated on October 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.