Ty Fullmer, DO - Medicare Emergency Medicine in Clinton Township, MI

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Ty Fullmer, DO is a medicare enrolled "Emergency Medicine" physician in Clinton Township, Michigan. His current practice location is 15855 19 Mile Rd, Clinton Township, Michigan. You can reach out to his office (for appointments etc.) via phone at (586) 263-2300.

Ty Fullmer is licensed to practice in Utah (license number 12811005-1204) 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 1679136758.

Contact Information

Ty Fullmer, DO
15855 19 Mile Rd,
Clinton Township, MI 48038-3504
(586) 263-2300
Not Available

Map and Direction




Physician's Profile

Full NameTy Fullmer
GenderMale
SpecialityEmergency Medicine
Location15855 19 Mile Rd, Clinton Township, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1679136758
  • Provider Enumeration Date: 04/15/2019
  • Last Update Date: 05/19/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3476888637
  • Enrollment ID: I20220913004135

Medical Identifiers

Medical identifiers for Ty Fullmer such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679136758NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 12811005-1204 (Utah)Primary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary

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. Ty Fullmer allows following entities to bill medicare on his behalf.
Entity NameUtah Emergency Physicians
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588048979
PECOS PAC ID: 1153307277
Enrollment ID: O20040628001454
Entity NameIhc Health Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942325154
PECOS PAC ID: 1850209420
Enrollment ID: O20080610000303

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. Ty Fullmer 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
Ty Fullmer, DO
15855 19 Mile Rd,
Clinton Township, MI 48038-3504

Ph: () -		Ty Fullmer, DO
15855 19 Mile Rd,
Clinton Township, MI 48038-3504

Ph: (586) 263-2300

Reviews and Comments


Emergency Medicine Doctors in Clinton Township, MI

Dr. Steven Denhof, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 15855 19 Mile Rd, Clinton Township, MI 48038
Phone: 586-263-2300    
Dr. James Lee, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 15855 19 Mile Rd, Clinton Township, MI 48038
Phone: 586-263-2950    
Nicole Adams, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 15855 19 Mile Rd, Clinton Township, MI 48038
Phone: 586-263-2300    
Dr. Jennifer Serene Wong, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 15855 19 Mile Rd, Clinton Township, MI 48038
Phone: 586-263-2953    
Dr. Ernesto M Juarez Jr., D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 15855 19 Mile Rd, Clinton Township, MI 48038
Phone: 586-263-2950    Fax: 586-263-2975
Dr. Costandinos Tsagaratos, D.O.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 15855 19 Mile Rd, Clinton Township, MI 48038
Phone: 586-263-2601    Fax: 586-263-2589
Dr. Emre Conklu, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 15855 19 Mile Rd, Office Of Medical Education, Clinton Township, MI 48038
Phone: 586-263-2300    

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).

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