DR. TIMOTHY RICHARD FULLAM M.D.
NPI 1952720104
Psychiatry & Neurology - Neuromuscular Medicine in Phoenix, AZ

Q: What is Timothy Fullam's NPI number?

The NPI number for Timothy Fullam is 1952720104. It was assigned to this individual provider in the NPPES registry on April 15, 2014.

Q: What is Timothy Fullam's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neuromuscular Medicine, with taxonomy code 2084N0008X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Fullam was last updated on February 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since April 15, 2014PECOS EnrolledAccepts Medicare Assignment

240 W THOMAS RD # 400, PHOENIX, AZ 85013(602) 406-6262(602) 406-6261 Get Directions Write a Review

NPPES record last updated: February 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 5, 2025, Jul 18, 2022, Aug 11, 2021 and 2 more (5 updates tracked since 2018).

On this page

About Dr. Timothy Richard Fullam M.d. NPPES

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

DR. TIMOTHY RICHARD FULLAM M.D. (NPI 1952720104) is an individual neuromuscular medicine provider in Phoenix, Arizona, licensed in Arizona (73815) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Pennsylvania State University College Of Medicine (2014).

NPPES Registry Identity

NPI1952720104

Entity TypeIndividualMale

Primary Taxonomy2084N0008X

Provider Legal NameDR. TIMOTHY RICHARD FULLAMCredential: M.D.

Location Address240 W THOMAS RD # 400Phoenix, AZ 85013-4407

Mailing Address240 W Thomas Rd Ste 301Phoenix, AZ 85013-4407 · (602) 406-6262

Phone(602) 406-6262

Fax(602) 406-6261

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 2014

Enumeration DateApril 15, 2014

Last NPPES UpdateFebruary 5, 20255 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2025

✔ NPI 1952720104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Neuromuscular MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2084N0008X

Licenses✔ Licensed in AZ · 73815✔ Licensed in TX · T1068

Definition

A neurologist or child neurologist who specializes in the diagnosis and management of disorders of nerve, muscle or neuromuscular junction, including amyotrophic lateral sclerosis, peripheral neuropathies (e.g., diabetic and immune mediated neuropathies), various muscular dystrophies, congenital and acquired myopathies, inflammatory myopathies (e.g., polymyositis, inclusion body myositis) and neuromuscular transmission disorders (e.g., myasthenia gravis, Lambert-Eaton myasthenic syndrome).

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License T1068 (TX)

Also ListedGeneral PracticeTaxonomy 208D00000X · License 28833 (NE)

240 W THOMAS RD # 400, Phoenix, AZ 85013

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Secondary Practice Locations 2

Location 1301 Fisher Street, 81 MDOS/SGOMUKeesler AFB, MS 39564 · Phone (228) 376-5378 · Fax (228) 376-0581

Location 23551 Roger Brooke DrJbsa Ft Sam Houston, TX 78234-4504 · Phone (210) 916-2203 · Fax (210) 916-2203

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.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

Dr. Timothy Richard Fullam M.d. 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 ID9830488691

PECOS Enrollment IDI20250515001276

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 2

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

33 services25 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

19 services14 patients

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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAY PATEL

Ophthalmology (Neuro-ophthalmology)