David A Fullenkamp, OD is a medicare enrolled "Optometrist" provider in Portland, Indiana. He graduated from medical school in 1985 and has 41 years of diverse experience with area of expertise as Optometry. He is a member of the group practice David A. Fullenkamp O.d P.c and his current practice location is
1111 N Meridian St, Portland, Indiana. You can reach out to his office (for appointments etc.) via phone at
(260) 726-4210.
David A Fullenkamp is licensed to practice in Indiana (license number 18002167A) 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 1043297625.
Healthcare Provider's Profile
| Full Name | David A Fullenkamp |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 41 Years |
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| Location | 1111 N Meridian St, Portland, Indiana |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- David A Fullenkamp graduated from medical school in 1985
NPI Data:
- NPI Number: 1043297625
- Provider Enumeration Date: 12/27/2005
- Last Update Date: 11/24/2009
Medicare PECOS Information:
- PECOS PAC ID: 2466355433
- Enrollment ID: I20060330000674
Medical Identifiers
Medical identifiers for David A Fullenkamp such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043297625 | NPI | - | NPPES |
| 100147120 | Medicaid | IN | |
| 2090544 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 18002167A (Indiana) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| David A. Fullenkamp O.d P.c | 0547308033 | 2 |
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. David A Fullenkamp allows following entities to bill medicare on his behalf.
| Provider Name | David A. Fullenkamp O.d P.c |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1346479284
PECOS PAC ID: 0547308033
Enrollment ID: O20091103000348 |
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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. David A Fullenkamp 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 |
|---|
David A Fullenkamp, OD
Po Box 1268,
Portland, IN 47371-3268
Ph: (260) 726-4210 | David A Fullenkamp, OD
1111 N Meridian St,
Portland, IN 47371-1024
Ph: (260) 726-4210 |
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