OMAR KEVIN FULLER
NPI 1932833050
Nurse Practitioner - Psychiatric/Mental Health in Loganville, GA
About Omar Kevin Fuller NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OMAR KEVIN FULLER (NPI 1932833050) is an individual psychiatric/mental health provider in Loganville, Georgia, licensed in Georgia (RN264780) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Omar Kevin 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.
Medicare Billing Reassignments
3Medicare enrollment records show Omar Fuller reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Snellville, GA 30078
- Reassigned Medicare billing, Florida and Georgia enrollments
Canton, GA 30114
- Reassigned Medicare billing, Georgia enrollment
- Medicare enrollment name: Highland Rivers Community Service Board
- 142 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Georgia enrollment
- 232 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 30052 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Omar Fuller's NPI number?
The NPI number for Omar Fuller is 1932833050. It was assigned to this individual provider in the NPPES registry on July 14, 2022.
Where is Omar Fuller located?
Omar Fuller practices at 487 Thomas Dr, Loganville, GA 30052. The listed phone number is (973) 572-8260.
What is Omar Fuller's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Omar Fuller enrolled in Medicare?
Yes. Omar 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 Omar Fuller's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Omar Fuller reassigns Medicare benefits to 3 organizations: Healthy Minds And Wellness (Snellville, GA), Highland Rivers Csb (Canton, GA) and Mental Health Specialty Group PA (Durham, NC). 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 Omar Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Omar Fuller accept?
Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Oscar Health, Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Omar Fuller as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Omar Fuller was last updated on July 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Omar Kevin Fuller · NPI 1932833050
Psychiatric/Mental Health physician in Loganville, Georgia. Individual provider, active in the CMS NPPES registry since July 14, 2022.
## Identity
- **NPI:** 1932833050 (Entity type: Individual)
- **Enumerated:** July 14, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** RN264780 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 487 THOMAS DR, Loganville, GA 30052-7262
- **Phone:** (973) 572-8260
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Healthy Minds And Wellness (NPI 1043020662, Snellville, GA); Highland Rivers Csb (NPI 1043373467, Canton, GA); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** July 14, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1932833050) · Data from the CMS NPPES public registry.