Jordan Louis Fuller, PT, DPT, LAT, ATC - Medicare Physical Therapist in Waltham, MA

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Jordan Louis Fuller, PT, DPT, LAT, ATC is a medicare enrolled "Physical Therapist" physician in Waltham, Massachusetts. His current practice location is 840 Winter St, Waltham, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (781) 487-9944.

Jordan Louis Fuller is licensed to practice in Massachusetts (license number 26548) 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 1992214803.

Contact Information

Jordan Louis Fuller, PT, DPT, LAT, ATC
840 Winter St,
Waltham, MA 02451-1433
(781) 487-9944
Not Available

Map and Direction




Physician's Profile

Full NameJordan Louis Fuller
GenderMale
SpecialityPhysical Therapist
Location840 Winter St, Waltham, Massachusetts
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1992214803
  • Provider Enumeration Date: 09/22/2017
  • Last Update Date: 11/10/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8628448727
  • Enrollment ID: I20230106000736

Medical Identifiers

Medical identifiers for Jordan Louis Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1992214803NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2081S0010XPhysical Medicine & Rehabilitation - Sports Medicine 3209 (Massachusetts)Secondary
225100000XPhysical Therapist 26548 (Massachusetts)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. Jordan Louis Fuller allows following entities to bill medicare on his behalf.
Entity NamePro Sports Therapy Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780661090
PECOS PAC ID: 6901708544
Enrollment ID: O20040123000313

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. Jordan Louis Fuller 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 AddressPractice Location Address
Jordan Louis Fuller, PT, DPT, LAT, ATC
50 Ocean Ave Apt 513a,
Revere, MA 02151-3897

Ph: (916) 337-4524		Jordan Louis Fuller, PT, DPT, LAT, ATC
840 Winter St,
Waltham, MA 02451-1433

Ph: (781) 487-9944

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.