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Active NPI 1417119652 Individual Practitioner Male Practitioner

Kevin S Fuller , PA-C

Physician Assistant • Fairfax, VA

Professional Overview & Biography Verified Profile Summary

Kevin Fuller, PA-C is a registered healthcare professional specializing in Physician Assistant in Fairfax, VA. Practice services are available at 13135 LEE JACKSON MEMORIAL HWY STE 305 under active NPI credentials.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, 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

13135 Lee Jackson Memorial Hwy Ste 305

Fairfax, VA 220331907

Telephone 7033598640
Fax 7035916105
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Fairfax, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.1 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
151 Specialists

Practicing in Fairfax, VA (4432 Statewide)

Telehealth Adoption Rate
20.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
76.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
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
44 22 $255.00 $60.42

Medical Specialties & State Licenses

CMS Verified: 2021-04-21
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License VA 0110001208

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1417119652 (VA)
Commercial Insurance / Payer ID License Number
0110001208 (VA)

Secondary Practice Locations

3620 Joseph Siewick Dr, Suite 406

Fairfax, VA 220331756

Phone: 7033598640

Practice Associates & Co-Workers

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

28 Associated Practitioners
NPI 1003802208

Doctor of Medicine (M.D.)

NPI 1033613021

Doctor of Medicine (M.D.)

Danielle Eganhouse , PA-C

Physician Assistant

NPI 1053764811

Physician Assistant (Certified)

Christine Gilloon , RD

Dietitian, Registered

NPI 1073097952

Registered Dietitian

Dr. Paul Savoca , MD

Colon & Rectal Surgery

NPI 1104817857

Doctor of Medicine (M.D.)

Han Nguyen , NP

Nurse Practitioner - Family

NPI 1164938247

Nurse Practitioner

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Business Mailing Address April 21, 2021

Registered at PO BOX 37174, BALTIMORE, MD 212973174 (Tel: 5714235699)

📍
Updated Business Mailing Address March 06, 2020

Registered at 13135 LEE JACKSON MEMORIAL HWY STE 305, FAIRFAX, VA 220331909 (Tel: 7033598640)

📍
Updated Practice Location August 21, 2019

Registered at 13135 LEE JACKSON MEMORIAL HWY STE 305, FAIRFAX, VA 220331907 (Tel: 7033598640)

NPI Profile Active January 04, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location January 04, 2012

Registered at 3620 JOSEPH SIEWICK DR, SUITE 406, FAIRFAX, VA 220331756 (Tel: 7033598640)

📍
Updated Business Mailing Address January 04, 2012

Registered at 3620 JOSEPH SIEWICK DR, SUITE 406, FAIRFAX, VA 220331756 (Tel: 7033598640)

👤
Provider Name / Credentials Updated January 04, 2012

Recorded as KEVIN FULLER, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 04, 2012

Physician Assistant (License #0110001208 in VA)

🟢
Initial NPI Registration & Enumeration June 30, 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: 1417119652
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2008
Last Update: April 21, 2021
Sole Proprietor: No

Mailing Address

Po Box 37174

Baltimore, MD 212973174

Phone: 5714235699

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.