JUSTIN WAYNE FULLER
NPI 1962176917
Nurse Anesthetist, Certified Registered in Mesa, AZ
About Justin Wayne Fuller NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUSTIN WAYNE FULLER (NPI 1962176917) is an individual nurse anesthetist, certified registered in Mesa, Arizona, licensed in Arizona (264564) and active in the NPI registry since August 2021. He is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
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
Justin Wayne 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.
Areas of Expertise CMS Part B claims
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.
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.
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.
MESA, AZ 85202
MESA, AZ 85202
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 Justin Fuller's NPI number?
The NPI number for Justin Fuller is 1962176917. It was assigned to this individual provider in the NPPES registry on August 3, 2021.
Where is Justin Fuller located?
Justin Fuller practices at 1400 S Dobson Rd, Mesa, AZ 85202. The listed phone number is (972) 761-5508.
What is Justin Fuller's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Justin Fuller enrolled in Medicare?
Yes. Justin 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 Justin Fuller accept?
Health plans from Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and Oscar Insurance Company list Justin 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 Justin Fuller was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.
# Justin Wayne Fuller · NPI 1962176917
Nurse Anesthetist, Certified Registered physician in Mesa, Arizona. Individual provider, active in the CMS NPPES registry since August 3, 2021.
## Identity
- **NPI:** 1962176917 (Entity type: Individual)
- **Enumerated:** August 3, 2021
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 264564 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 1400 S DOBSON RD, Mesa, AZ 85202-4707
- **Phone:** (972) 761-5508
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** September 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1962176917) · Data from the CMS NPPES public registry.