OMAR KEVIN FULLER
NPI 1932833050
Nurse Practitioner - Psychiatric/Mental Health in Loganville, GA

Active since July 14, 2022PECOS EnrolledAccepts Medicare Assignment
487 THOMAS DR, LOGANVILLE, GA 30052(973) 572-8260 Get Directions Write a Review

NPPES record last updated: July 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1932833050
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameOMAR KEVIN FULLER
Location Address487 THOMAS DRLoganville, GA 30052-7262
Mailing Address487 Thomas DrLoganville, GA 30052-7262 · (973) 572-8260
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 14, 2022
NPPES CertifiedJuly 13, 2022
NPI 1932833050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in GA · RN264780
487 THOMAS DR, Loganville, GA 30052

Accepted Insurance

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

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.

PECOS PAC ID9133594401
PECOS Enrollment IDI20230419001025, I20250211001160
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.

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.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

What insurance does Omar Fuller accept?

Health plans from 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.