Connor M Fultz, MD in Willow Grove, PA - Medicare Physical Medicine & Rehabilitation

Connor M Fultz, MD is a medicare enrolled "Physical Medicine & Rehabilitation - Sports Medicine" physician in Willow Grove, Pennsylvania. His current practice location is 2400 Maryland Rd Ste 20, Willow Grove, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (800) 321-9999.

Connor M Fultz is licensed to practice in Pennsylvania (license number MD486957) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003435132.

Contact Information

	Connor M Fultz, MD
	2400 Maryland Rd Ste 20, Willow Grove, PA 19090-1732
	(800) 321-9999
	(267) 479-1321

Map and Direction

Physician's Profile

Full Name	Connor M Fultz
Gender	Male
Speciality	Physical Medicine & Rehabilitation - Sports Medicine
Location	2400 Maryland Rd Ste 20, Willow Grove, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003435132
Provider Enumeration Date: 04/09/2020
Last Update Date: 09/02/2025

Medicare PECOS Information:

PECOS PAC ID: 8022439694
Enrollment ID: I20241118002309

Medical Identifiers

Medical identifiers for Connor M Fultz such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003435132	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2081S0010X	Physical Medicine & Rehabilitation - Sports Medicine	MD486957 (Pennsylvania)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Connor M Fultz allows following entities to bill medicare on his behalf.

Entity Name	University Of Pittsburgh Physicians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619935004 PECOS PAC ID: 8729990239 Enrollment ID: O20040308000883

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Connor M Fultz is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Connor M Fultz, MD 833 Chestnut St Ste 520, Philadelphia, PA 19107-4430 Ph: (609) 677-7003	Connor M Fultz, MD 2400 Maryland Rd Ste 20, Willow Grove, PA 19090-1732 Ph: (800) 321-9999

Reviews and Comments

Physical Medicine & Rehabilitation Doctors in Willow Grove, PA

Richard Goldberg, DO Physical Medicine & Rehabilitation Medicare: Medicare Enrolled Practice Location: 2400 Maryland Rd, Suite 20, Willow Grove, PA 19090 Phone: 215-830-8700 Fax: 215-830-8715
David Mancini, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 2400 Maryland Rd, Suite 20, Willow Grove, PA 19090 Phone: 215-830-8700 Fax: 215-830-8715
Bradley J. Ferrara, MD Physical Medicine & Rehabilitation Medicare: Medicare Enrolled Practice Location: 2325 Maryland Road Suite 200, Willow Grove, PA 19090 Phone: 215-657-9393 Fax: 215-657-9398
Amelia L A Tabuena, MD Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 701 Easton Rd, Willow Grove, PA 19090 Phone: 215-830-9568 Fax: 215-830-9579
Isaiah Levy, M.D. Physical Medicine & Rehabilitation Medicare: Medicare Enrolled Practice Location: 2325 Maryland Rd Ste 100, Willow Grove, PA 19090 Phone: 855-862-7767
Theerasakdi Vachranukunkiet, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 701 Easton Rd, Willow Grove, PA 19090 Phone: 215-820-9568 Fax: 215-830-9579

Connor M Fultz, MD - Medicare Physical Medicine & Rehabilitation in Willow Grove, PA