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PAUL FULGHUM OD PA
NPI 1962436121
Optometrist in Jacksonville, FL

Active since July 11, 2006PECOS Enrolled
4225 LAKESIDE DR, JACKSONVILLE, FL 32210(904) 387-5704(904) 387-5751 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Paul Fulghum Od Pa NPPES

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

PAUL FULGHUM OD PA (NPI 1962436121) is an individual optometrist in Jacksonville, Florida, licensed in Florida (1834) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962436121
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NamePAUL FULGHUMCredential: OD PA
Location Address4225 LAKESIDE DRJacksonville, FL 32210-3305
Mailing Address4225 Lakeside DrJacksonville, FL 32210-3305 · (904) 387-5704 · Fax (904) 387-5751
Phone(904) 387-5704
Fax(904) 387-5751
Sole ProprietorYes
Enumeration DateJuly 11, 2006
Last NPPES UpdateNovember 29, 2023
✔ NPI 1962436121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in FL · 1834
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
4225 LAKESIDE DR, Jacksonville, FL 32210
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Other Identifiers 1

Medicaid086952300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paul Fulghum Od Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Paul Fulghum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Aeg Florida Professional PLLC
15 mi
Optometrist
4788 HODGES BLVD STE 205
Jacksonville, FL 32224
  • Reassigned Medicare billing, Florida enrollment
  • 110 clinicians in this Medicare group
NPI 1164156246 (904) 992-9991

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
108 services67 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
94 services94 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
37 services37 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
34 services30 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
24 services21 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
19 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32210 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
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.

Other Providers at the Same Location NPPES 2

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

DR. MICHAEL STUART NASON O.D.
Optometrist
4225 LAKESIDE DR
JACKSONVILLE, FL 32210
Duval County (904) 387-5704
PAUL FULGHUM OD PA
Optometrist
4225 LAKESIDE DR
JACKSONVILLE, FL 32210
Duval County (904) 387-5704

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 Paul Fulghum's NPI number?

The NPI number for Paul Fulghum is 1962436121. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Paul Fulghum located?

Paul Fulghum practices at 4225 Lakeside Dr, Jacksonville, FL 32210. The listed phone number is (904) 387-5704.

What is Paul Fulghum's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Paul Fulghum enrolled in Medicare?

Yes. Paul Fulghum is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Paul Fulghum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Fulghum reassigns Medicare benefits to Aeg Florida Professional PLLC (Jacksonville, FL). The 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 Paul Fulghum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paul Fulghum accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Paul Fulghum 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 Paul Fulghum was last updated on November 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.