Phillip Tyler Fuller, MD - Medicare Urology in Ada, OK

Phillip Tyler Fuller, MD is a medicare enrolled "Urology" physician in Ada, Oklahoma. He went to University Of Oklahoma College Of Medicine and graduated in 2009 and has 15 years of diverse experience with area of expertise as Urology. He is a member of the group practice Chickasaw Nation Division Of Health and his current practice location is 1414 Arlington Street, Suite 2300, Ada, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (580) 332-0112.

Phillip Tyler Fuller is licensed to practice in Oklahoma (license number 30483) 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 1871720300.

Contact Information

Phillip Tyler Fuller, MD
1414 Arlington Street, Suite 2300,
Ada, OK 74820
(580) 332-0112
(580) 332-1005



Physician's Profile

Full NamePhillip Tyler Fuller
GenderMale
SpecialityUrology
Experience15 Years
Location1414 Arlington Street, Ada, Oklahoma
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Phillip Tyler Fuller attended and graduated from University Of Oklahoma College Of Medicine in 2009
  NPI Data:
  • NPI Number: 1871720300
  • Provider Enumeration Date: 06/11/2009
  • Last Update Date: 06/25/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 9335373802
  • Enrollment ID: I20141201001941

Medical Identifiers

Medical identifiers for Phillip Tyler Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871720300NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology 30483 (Oklahoma)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Chickasaw Nation Medical CenterAda, OKHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Chickasaw Nation Division Of Health8426957523209

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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. Phillip Tyler Fuller allows following entities to bill medicare on his behalf.
Entity NameChickasaw Nation Division Of Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255364923
PECOS PAC ID: 8426957523
Enrollment ID: O20040108000364

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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. Phillip Tyler 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 AddressPractice Location Address
Phillip Tyler Fuller, MD
1414 Arlington Street, Suite 2300,
Ada, OK 74820

Ph: (580) 332-0112
Phillip Tyler Fuller, MD
1414 Arlington Street, Suite 2300,
Ada, OK 74820

Ph: (580) 332-0112

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Urology Doctors in Ada, OK


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