Dr Mark Avery Fuller, MD in Bayfield, WI - Medicare General Practice

Dr Mark Avery Fuller, MD is a medicare enrolled "Internal Medicine" physician in Bayfield, Wisconsin. He went to Michigan State University College Of Human Medicine and graduated in 1996 and has 28 years of diverse experience with area of expertise as General Practice. He is a member of the group practice Red Cliff Band Of Lake Superior Chippewa Indians and his current practice location is 36745 Aiken Rd, Bayfield, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (715) 779-3707.

Dr Mark Avery Fuller is licensed to practice in Wisconsin (license number 1901-320) 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 1124055561.

Contact Information

	Dr Mark Avery Fuller, MD
	36745 Aiken Rd, Bayfield, WI 54814-4579
	(715) 779-3707
	(715) 779-3362

Map and Direction

Physician's Profile

Full Name	Dr Mark Avery Fuller
Gender	Male
Speciality	General Practice
Experience	28 Years
Location	36745 Aiken Rd, Bayfield, Wisconsin
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:

Dr Mark Avery Fuller attended and graduated from Michigan State University College Of Human Medicine in 1996

NPI Data:

NPI Number: 1124055561
Provider Enumeration Date: 06/28/2006
Last Update Date: 06/21/2022

Medicare PECOS Information:

PECOS PAC ID: 3577587351
Enrollment ID: I20220719002767

Medical Identifiers

Medical identifiers for Dr Mark Avery Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124055561	NPI	-	NPPES
3536500	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208M00000X	Hospitalist	4301093004 (Michigan)	Secondary
207R00000X	Internal Medicine	1901-320 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Medical Center	Ashland, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Red Cliff Band Of Lake Superior Chippewa Indians	4284537580	11

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. Dr Mark Avery Fuller allows following entities to bill medicare on his behalf.

Entity Name	Red Cliff Band Of Lake Superior Chippewa Indians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497744015 PECOS PAC ID: 4284537580 Enrollment ID: O20040202000406

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. Dr Mark Avery 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
Dr Mark Avery Fuller, MD 638 Lake Ave, Ironwood, MI 49938-1424 Ph: (906) 364-7105	Dr Mark Avery Fuller, MD 36745 Aiken Rd, Bayfield, WI 54814-4579 Ph: (715) 779-3707

Dr Mark Avery Fuller, MD - Medicare General Practice in Bayfield, WI