Clark J Fullmer Ii, DPM - Medicare Podiatrist in Dickinson, ND

Clark J Fullmer Ii, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Dickinson, North Dakota. He went to California School Of Podiatric Medicine and graduated in 1995 and has 29 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Omaha Therapy Inc, Sanford Bismarck and his current practice location is 2615 Fairway St, Dickinson, North Dakota. You can reach out to his office (for appointments etc.) via phone at (701) 456-6000.

Clark J Fullmer Ii is licensed to practice in North Dakota (license number 60) 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 1649240557.

Contact Information

Clark J Fullmer Ii, DPM
2615 Fairway St,
Dickinson, ND 58601
(701) 456-6000
Not Available



Healthcare Provider's Profile

Full NameClark J Fullmer Ii
GenderMale
SpecialityPodiatry
Experience29 Years
Location2615 Fairway St, Dickinson, North Dakota
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:
  • Clark J Fullmer Ii attended and graduated from California School Of Podiatric Medicine in 1995
  NPI Data:
  • NPI Number: 1649240557
  • Provider Enumeration Date: 01/24/2006
  • Last Update Date: 08/30/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 4981708567
  • Enrollment ID: I20100127000303

Medical Identifiers

Medical identifiers for Clark J Fullmer Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1649240557NPI-NPPES
14953MedicaidND

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213ES0103XPodiatrist - Foot & Ankle Surgery 60 (North Dakota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Chi St Alexius Health DickinsonDickinson, NDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Omaha Therapy Inc155727091545
Sanford Bismarck9739098575448

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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. Clark J Fullmer Ii allows following entities to bill medicare on his behalf.
Provider NameSanford Bismarck
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1811941172
PECOS PAC ID: 9739098575
Enrollment ID: O20031105000403

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Provider NameSanford Bismarck
Provider TypePart B Supplier - Ambulatory Surgical Center
Provider IdentifiersNPI Number: 1598185597
PECOS PAC ID: 9739098575
Enrollment ID: O20040304000249

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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. Clark J Fullmer Ii 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
Clark J Fullmer Ii, DPM
2615 Fairway St,
Dickinson, ND 58601-2590

Ph: (701) 456-6000
Clark J Fullmer Ii, DPM
2615 Fairway St,
Dickinson, ND 58601

Ph: (701) 456-6000

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Podiatrist in Dickinson, ND

Dr. Cherian Mathew, D.P.M.
Podiatrist
Medicare: Not Enrolled in Medicare
Practice Location: 2215 Sims St, Dickinson, ND 58601
Phone: 701-483-6986    Fax: 701-483-6974

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