DR. JONATHAN ELLIS FULLER M.D. NPI 1053314443

NPI Information

  • NPI: 1053314443
  • Provider Name: DR. JONATHAN ELLIS FULLER, M.D.
  • Classification: Orthopaedic Surgery - 207XS0117X
  • Specialization: Orthopaedic Surgery of the Spine
  • Entity Type: Individual
  • Address: 13616 CALIFORNIA ST
    STE 100
    OMAHA, NE
    ZIP 68154
  • Phone: (402) 496-0404

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NPI Details

DR. Jonathan Ellis Fuller, M.D. is an orthopaedic surgery of the spine orthopaedic surgery in Omaha, NE. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. DR. Jonathan Ellis Fuller, M.D. NPI is 1053314443. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

13616 CALIFORNIA ST
STE 100
OMAHA, NE
ZIP 68154-335
Phone: (402) 496-0404
Fax: (402) 496-0517

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of lower and sacral spine, minimum of 4 views (HCPCS:72110)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • Insertion of cage or mesh device to spine bone and disc space during spine fusion (HCPCS:22853)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • X-ray of upper spine, 4-5 views (HCPCS:72050)
  • Ct scan of lower spine without contrast (HCPCS:72131)
  • Computer-assisted spinal procedure (HCPCS:61783)
  • Fusion of spine in lower back with partial removal of spine bone and disc (HCPCS:22633)
  • Placement of stabilizing device to back, 3-6 spine bone segments (HCPCS:22842)
  • Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back (HCPCS:63052)
  • Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back (HCPCS:63053)
  • Placement of stabilizing device to back of 1 spine bone in neck (HCPCS:22840)
  • X-ray of entire middle and lower spine, 2-3 views (HCPCS:72082)
  • X-ray of middle spine, 2 views (HCPCS:72070)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)

The enumeration date for this NPI number is 5/31/2005 and was last updated on 1/28/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine20813NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
147081304012MEDICAIDNEBRASKA
2F08923MEDICARE UPINNEBRASKA
307113OTHERNEBRASKABCBS
4200031840OTHERNEBRASKARAILROAD MEDICARE
50511642MEDICAIDIOWA
6270600MEDICARE PINNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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