Omar Kevin Fuller, in Loganville, GA - Medicare Nurse Practitioner

Omar Kevin Fuller, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Loganville, Georgia. He graduated from nursing school in 2022 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Highland Rivers Community Service Board and his current practice location is 487 Thomas Dr, Loganville, Georgia. You can reach out to his office (for appointments etc.) via phone at (973) 572-8260.

Omar Kevin Fuller is licensed to practice in Georgia (license number RN264780) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1932833050.

Contact Information

	Omar Kevin Fuller,
	487 Thomas Dr, Loganville, GA 30052-7262
	(973) 572-8260
	Not Available

Map and Direction

Provider's Profile

Full Name	Omar Kevin Fuller
Gender	Male
Speciality	Nurse Practitioner
Experience	3 Years
Location	487 Thomas Dr, Loganville, Georgia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Omar Kevin Fuller graduated from nursing school in 2022

NPI Data:

NPI Number: 1932833050
Provider Enumeration Date: 07/14/2022
Last Update Date: 07/14/2022

Medicare PECOS Information:

PECOS PAC ID: 9133594401
Enrollment ID: I20230419001025

Medical Identifiers

Medical identifiers for Omar Kevin Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932833050	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	RN264780 (Georgia)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Highland Rivers Community Service Board	9032000245	51

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. Omar Kevin Fuller allows following entities to bill medicare on his behalf.

Entity Name	Highland Rivers Community Service Board
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447256243 PECOS PAC ID: 9032000245 Enrollment ID: O20040324001204

Entity Name	Healthy Minds And Wellness
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043020662 PECOS PAC ID: 3476083478 Enrollment ID: O20250205003708

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. Omar Kevin 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 Address	Practice Location Address
Omar Kevin Fuller, 487 Thomas Dr, Loganville, GA 30052-7262 Ph: (973) 572-8260	Omar Kevin Fuller, 487 Thomas Dr, Loganville, GA 30052-7262 Ph: (973) 572-8260

Reviews and Comments

Nurse Practitioner Nurses in Loganville, GA

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Ashley Owen, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4593 Lawrenceville Rd, Loganville, GA 30052 Phone: 770-466-8672

Omar Kevin Fuller, - Medicare Nurse Practitioner in Loganville, GA