Active NPI 1760575229 Individual Practitioner Male Practitioner

Dr. James K Fullerton , MD

Surgery • Springfield, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. James Fullerton, MD is a certified Surgery practicing in Springfield, IL. With approximately 27 years of clinical experience since graduating from Medical College Of Wisconsin in 1999, Dr. Fullerton delivers high-quality medical care to the local community at 900 N 1ST ST.

Dr. Fullerton is affiliated with Springfield Clinic, Llp and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, new patient outpatient office visit, initial hospital care with moderate level of medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

900 N 1st St

Springfield, IL 627023749

Telephone 2175287541

Fax 2177442537

Associated Practice Facility / Clinic

🏢 Springfield Clinic, Llp Facility NPI 1780638478

Medicare Profile & Education

Medical School

Medical College Of Wisconsin

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Springfield, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs +8.8 yrs vs City Avg

City Avg: 18.2 Yrs

State Avg: 27.3 Yrs

Regional Practice Density

55 Specialists

Practicing in Springfield, IL (1624 Statewide)

Telehealth Adoption Rate

3.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

88.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fullerton (27 Years) 27 Yrs

Springfield Specialty Average (18.2 Years) 18.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	139	44	$518.00	$115.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	58	58	$765.93	$154.57
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	54	53	$893.00	$164.73
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	39	36	$1715.18	$123.15
36415 Insertion of needle into vein for collection of blood sample	35	35	$8.40	$8.10
99213 Established patient office or other outpatient visit, typically 15 minutes	28	23	$411.86	$88.40
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	26	26	$4059.15	$724.93
43264 Removal of stone from bile or pancreatic duct using an endoscope	25	22	$2941.00	$189.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	24	$583.25	$120.08
49650 Repair of groin hernia using an endoscope	17	17	$4494.09	$475.07
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	15	15	$9170.00	$1326.38
43262 Incision of pancreatic outlet using a flexible endoscope	14	14	$2714.00	$53.71
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	13	12	$242.92	$17.89
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	13	12	$5696.00	$330.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$517.73	$105.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	145	55	$471.00	$117.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	74	74	$741.00	$161.73
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	74	72	$893.00	$171.60
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	43	43	$1696.00	$127.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	37	$555.00	$124.19
99213 Established patient office or other outpatient visit, typically 15 minutes	39	34	$382.00	$86.29
36415 Insertion of needle into vein for collection of blood sample	34	32	$6.00	$5.88
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	29	29	$3968.03	$737.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$496.00	$109.46
43264 Removal of stone from bile or pancreatic duct using an endoscope	21	19	$2941.00	$209.54
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	19	19	$5696.00	$301.39
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	18	18	$576.00	$17.95
99238 Hospital discharge day management, 30 minutes or less	17	16	$328.00	$79.42
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	17	17	$8275.24	$1346.62
49650 Repair of groin hernia using an endoscope	16	16	$4312.88	$503.12
43262 Incision of pancreatic outlet using a flexible endoscope	11	11	$2714.00	$32.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	116	50	$471.00	$100.35
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	59	59	$659.24	$165.61
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	58	55	$493.59	$125.84
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	55	53	$893.00	$193.26
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	45	44	$1664.42	$126.87
43264 Removal of stone from bile or pancreatic duct using an endoscope	26	25	$2941.00	$195.41
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	25	25	$3984.04	$738.43
49650 Repair of groin hernia using an endoscope	25	25	$4731.84	$489.73
99213 Established patient office or other outpatient visit, typically 15 minutes	24	21	$350.42	$88.90
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	19	19	$8526.00	$1392.87
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$473.42	$110.71
99238 Hospital discharge day management, 30 minutes or less	15	15	$328.00	$70.49
43274 Insertion of stent into pancreatic or bile duct using a flexible endoscope	14	14	$2577.00	$447.86
43262 Incision of pancreatic outlet using a flexible endoscope	13	13	$2714.00	$34.11
36415 Insertion of needle into vein for collection of blood sample	12	12	$6.00	$2.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	73	38	$471.00	$102.61
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$615.00	$165.01
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	51	50	$893.00	$198.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	44	41	$461.00	$128.00
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	39	37	$1638.00	$132.58
43264 Removal of stone from bile or pancreatic duct using an endoscope	30	28	$2965.51	$225.59
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	22	22	$8622.89	$1547.40
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	21	21	$3960.10	$748.01
99213 Established patient office or other outpatient visit, typically 15 minutes	21	19	$317.00	$87.04
49650 Repair of groin hernia using an endoscope	19	19	$4496.63	$490.62
43262 Incision of pancreatic outlet using a flexible endoscope	18	17	$2751.69	$91.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$441.00	$111.07
43274 Insertion of stent into pancreatic or bile duct using a flexible endoscope	17	17	$2577.00	$426.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	128	51	$454.00	$105.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	57	57	$570.00	$163.93
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	47	46	$828.00	$204.88
43264 Removal of stone from bile or pancreatic duct using an endoscope	31	29	$2941.00	$285.25
99213 Established patient office or other outpatient visit, typically 15 minutes	28	23	$294.00	$74.01
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	25	25	$4022.72	$768.30
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	24	23	$1638.00	$122.17
43262 Incision of pancreatic outlet using a flexible endoscope	22	22	$2714.00	$65.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	20	$427.00	$107.92
49650 Repair of groin hernia using an endoscope	17	17	$4687.38	$493.66
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	14	14	$784.00	$207.63
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	14	14	$5696.00	$331.07
99238 Hospital discharge day management, 30 minutes or less	14	14	$328.00	$73.36
99220 Hospital observation care, typically 70 minutes	13	13	$762.00	$188.00
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	11	11	$457.91	$19.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	204	72	$162.32	$104.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	75	75	$226.19	$156.94
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	61	58	$291.31	$202.54
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	38	37	$512.39	$120.71
43264 Removal of stone from bile or pancreatic duct using an endoscope	32	28	$731.90	$253.18
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	32	32	$1294.95	$747.58
36415 Insertion of needle into vein for collection of blood sample	29	28	$3.10	$2.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	22	$127.05	$103.66
43262 Incision of pancreatic outlet using a flexible endoscope	22	22	$827.62	$66.64
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	21	21	$250.45	$204.41
99238 Hospital discharge day management, 30 minutes or less	15	15	$96.21	$72.74
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	14	14	$2835.55	$1645.50
49650 Repair of groin hernia using an endoscope	14	14	$1207.79	$462.92
99213 Established patient office or other outpatient visit, typically 15 minutes	13	12	$96.01	$72.62
43274 Insertion of stent into pancreatic or bile duct using a flexible endoscope	11	11	$529.98	$462.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	168	70	$114.95	$102.34
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	75	74	$220.33	$200.90
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	63	63	$181.33	$158.47
36415 Insertion of needle into vein for collection of blood sample	43	40	$3.00	$2.94
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	41	38	$425.13	$132.64
99213 Established patient office or other outpatient visit, typically 15 minutes	41	36	$79.91	$70.67
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	40	40	$1008.55	$720.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	27	$114.74	$104.29
99238 Hospital discharge day management, 30 minutes or less	28	26	$79.01	$71.98
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	24	24	$222.59	$203.04
43264 Removal of stone from bile or pancreatic duct using an endoscope	23	21	$417.46	$266.44
49650 Repair of groin hernia using an endoscope	17	17	$706.65	$504.28
43262 Incision of pancreatic outlet using a flexible endoscope	15	15	$404.82	$56.50
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	11	11	$9.59	$9.40
43274 Insertion of stent into pancreatic or bile duct using a flexible endoscope	11	11	$525.09	$456.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	139	70	$84.25	$68.59
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	87	83	$230.34	$195.33
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	84	47	$115.88	$102.06
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	67	65	$415.55	$132.66
36415 Insertion of needle into vein for collection of blood sample	47	43	$3.04	$2.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$183.87	$154.38
99213 Established patient office or other outpatient visit, typically 15 minutes	43	38	$79.94	$68.61
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	38	38	$228.61	$197.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	34	32	$114.89	$103.53
43264 Removal of stone from bile or pancreatic duct using an endoscope	29	26	$416.48	$206.92
99238 Hospital discharge day management, 30 minutes or less	29	27	$93.29	$64.47
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	29	29	$841.15	$737.40
43261 Biopsy of gallbladder, pancreatic, liver, and bile ducts using a flexible endoscope	20	19	$387.24	$82.81
43274 Insertion of stent into pancreatic or bile duct using a flexible endoscope	19	19	$529.98	$452.23
43262 Incision of pancreatic outlet using a flexible endoscope	17	17	$408.74	$191.36
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	16	16	$706.39	$337.94
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	15	15	$1801.16	$1606.32
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	14	14	$66.58	$18.20
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$46.20	$41.60

Medical Specialties & State Licenses

CMS Verified: 2020-05-22

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License IL 036-110732

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036110732 (IL)

Hospital & Practice Group Affiliations

Springfield Clinic, Llp

800 N 1st St, Springfield, IL 627023719

Phone: 2175287541

Springfield Clinic, Llp

1025 S 6th St, Springfield, IL 627032403

Phone: 2175287541

Springfield Clinic, Llp

800 E Carpenter St, Springfield, IL 627025324

Phone: 2175446464

Springfield Clinic, Llp

747 N Rutledge St, Springfield, IL 627026700

Phone: 2177572257

Springfield Clinic, Llp

775 Engineering Ave, Springfield, IL 627035909

Phone: 2175224300

Springfield Clinic, Llp

350 W Carpenter St, Springfield, IL 627024902

Phone: 2175250210

Springfield Clinic, Llp

747 N Rutlage Baylis Medical Bld, Springfield, IL 627026700

Phone: 2175457722

Springfield Clinic, Llp

2200 Wabash Ave, Springfield, IL 627045352

Phone: 2177870727

Springfield Clinic, Llp

900 N 1st St, Springfield, IL 627023749

Phone: 2175287541

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Kaitlin Henry , MD

Family Medicine

NPI 1003136276

Doctor of Medicine (M.D.)

Sydney Lynch

Physician Assistant - Surgical

NPI 1003404864

Jeremy Elliott

Nurse Practitioner - Family

NPI 1003416546

Jessica Lee , APN

Nurse Practitioner - Family

NPI 1003461831

Advanced Practice Nurse

Julie Hart , PA-C

Physician Assistant

NPI 1003867342

Physician Assistant (Certified)

Barbara Wolfson , LCPC

Counselor

NPI 1003900739

Licensed Clinical Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 17, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location February 17, 2015

Registered at 900 N 1ST ST, SPRINGFIELD, IL 627023749 (Tel: 2175287541)

📍

Updated Business Mailing Address February 17, 2015

Registered at 1025 S 6TH ST, SPRINGFIELD, IL 627032403 (Tel: 2175287541)

👤

Provider Name / Credentials Updated February 17, 2015

Recorded as JAMES FULLERTON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 17, 2015

Surgery (License #036-110732 in IL)

🟢

Initial NPI Registration & Enumeration October 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760575229

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 02, 2006

Last Update: May 22, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1025 S 6th St

Springfield, IL 627032403

Phone: 2175287541

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.