Jared Russel Fuller, DO is a medicare enrolled "Anesthesiology" physician in Apo, Armed Forces Americas. He graduated from medical school in 2008 and has 16 years of diverse experience with area of expertise as Anesthesiology. He is a member of the group practice San Juan Regional Medical Center, Inc. and his current practice location is
4700 North Las Vegas Blvd, Apo, Armed Forces Americas. You can reach out to his office (for appointments etc.) via phone at
(702) 653-3553.
Jared Russel Fuller is licensed to practice in Nevada (license number DO1717) 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 1669649117.
Physician's Profile
| Full Name | Jared Russel Fuller |
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| Gender | Male |
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| Speciality | Anesthesiology |
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| Experience | 16 Years |
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| Location | 4700 North Las Vegas Blvd, Apo, Armed Forces Americas |
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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:
- Jared Russel Fuller graduated from medical school in 2008
NPI Data:
- NPI Number: 1669649117
- Provider Enumeration Date: 05/14/2008
- Last Update Date: 02/13/2013
Medicare PECOS Information:
- PECOS PAC ID: 4183869258
- Enrollment ID: I20161103002003
Medical Identifiers
Medical identifiers for Jared Russel Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669649117 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207L00000X | Anesthesiology | DO1717 (Nevada) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| San Juan Regional Medical Center, Inc. | 4587559505 | 177 |
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. Jared Russel Fuller allows following entities to bill medicare on his behalf.
| Entity Name | San Juan Regional Medical Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1639662901
PECOS PAC ID: 4587559505
Enrollment ID: O20040218000865 |
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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. Jared Russel 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 |
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Jared Russel Fuller, DO
7435 Dumbarton Oaks St,
Las Vegas, NV 89166-5227
Ph: () - | Jared Russel Fuller, DO
4700 North Las Vegas Blvd,
Apo, AA 89191
Ph: (702) 653-3553 |