Active NPI 1255599163 Individual Practitioner Male Practitioner

Michael John Fullam , PA

Physician Assistant • Patchogue, NY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Michael Fullam, PA is a certified Physician Assistant practicing in Patchogue, NY. With approximately 29 years of clinical experience since completing medical education in 1997, Michael Fullam delivers high-quality medical care to the local community at 107 N OCEAN AVE.

Michael Fullam is affiliated with New York University and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only, routine ekg using at least 12 leads including interpretation and report. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

107 N Ocean Ave

Patchogue, NY 117722012

Telephone 6316545004

Associated Practice Facility / Clinic

🏢 Cherese M. Laporta D.o., Pllc Facility NPI 1700050051

Medicare Profile & Education

Medical School

Other

Graduation Year

1997

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Patchogue, NY

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

29 Yrs +21.3 yrs vs City Avg

City Avg: 7.7 Yrs

State Avg: 12.0 Yrs

Regional Practice Density

81 Specialists

Practicing in Patchogue, NY (15701 Statewide)

Telehealth Adoption Rate

2.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

85.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fullam (29 Years) 29 Yrs

Patchogue Specialty Average (7.7 Years) 7.7 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
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	91	60	$444.00	$71.25
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	81	77	$55.00	$7.59
93000 Routine ekg using at least 12 leads including interpretation and report	77	74	$182.00	$13.84
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	71	70	$832.00	$126.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	66	64	$688.00	$122.75
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	51	50	$119.00	$15.59
36415 Insertion of needle into vein for collection of blood sample	17	14	$25.00	$8.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$1155.00	$152.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	80	55	$355.00	$74.23
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	61	59	$44.00	$7.94
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	61	60	$665.00	$132.19
93793 Anticoagulant management of patient taking warfarin	34	25	$69.00	$11.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	11	11	$550.00	$128.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	94	83	$44.00	$8.21
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	85	84	$665.00	$127.57
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	74	48	$355.00	$69.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	47	47	$550.00	$129.83
93000 Routine ekg using at least 12 leads including interpretation and report	37	37	$145.00	$14.97
85610 Blood test, clotting time	18	16	$40.00	$4.27
93793 Anticoagulant management of patient taking warfarin	14	13	$69.00	$11.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	74	71	$44.00	$8.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	62	$550.00	$131.85
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	61	61	$665.00	$129.74
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	55	37	$355.00	$70.18
93000 Routine ekg using at least 12 leads including interpretation and report	44	44	$145.00	$15.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	34	33	$44.00	$8.53
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	31	31	$665.00	$130.14
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	18	$550.00	$111.37
93000 Routine ekg using at least 12 leads including interpretation and report	17	17	$145.00	$17.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	63	60	$370.00	$107.96
93000 Routine ekg using at least 12 leads including interpretation and report	51	48	$80.00	$17.26
99213 Established patient office or other outpatient visit, typically 15 minutes	19	19	$250.00	$74.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	68	66	$370.00	$111.16
93000 Routine ekg using at least 12 leads including interpretation and report	43	43	$80.00	$18.04
99213 Established patient office or other outpatient visit, typically 15 minutes	19	19	$250.00	$75.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93000 Routine ekg using at least 12 leads including interpretation and report	20	19	$63.50	$16.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	13	$277.00	$105.37
99213 Established patient office or other outpatient visit, typically 15 minutes	12	11	$197.50	$70.03

Medical Specialties & State Licenses

CMS Verified: 2021-02-25

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NY 006268

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

New York University

111 Broadway, New York, NY 100061901

Phone: 2122639700

New York University

78 Old Country Rd, Westhampton, NY 119771219

Phone: 6312880101

Practice Associates & Co-Workers

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

4 Associated Practitioners

Jennifer Santoro , PA-C

Family Medicine

NPI 1144795824

Physician Assistant (Certified)

Allison Boyle , PA

Physician Assistant - Medical

NPI 1285988642

Physician Assistant

Dr. Cherese Laporta , DO

Family Medicine

NPI 1437206943

Doctor of Osteopathic Medicine (D.O.)

Vanessa Petoello , ANP

Nurse Practitioner - Adult Health

NPI 1992251631

Adult Nurse Practitioner

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active May 28, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location May 28, 2008

Registered at 107 N OCEAN AVE, PATCHOGUE, NY 117722012 (Tel: 6316545004)

📍

Updated Business Mailing Address May 28, 2008

Registered at 25 NORTHUMBERLAND DR, SHOREHAM, NY 117862000 (Tel: 6318466984)

👤

Provider Name / Credentials Updated May 28, 2008

Recorded as MICHAEL FULLAM, PA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2008

Physician Assistant (License #006268 in NY)

🟢

Initial NPI Registration & Enumeration May 28, 2008

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: 1255599163

Entity Type:

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

Enumeration Date: May 28, 2008

Last Update: February 25, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

25 Northumberland Dr

Shoreham, NY 117862000

Phone: 6318466984

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.