Ty Fullmer, DO
NPI 1679136758ActiveIndividual· Emergency Medicine· Clinton Township, MI
Emergency Medicine (DO) with Ihc Health Services Inc and 1 other group, practicing in Clinton Township, Michigan. 223 Medicare patients in 2024, $29,376 paid; nearly all of their 116 Part D prescriptions were generic (95%). Lists Intermountain Health Layton Hospital and 1 other hospital as hospital affiliations.
Overview
| NPI | 1679136758 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | No |
| NPI issued | Apr 15, 2019 |
| Last updated in NPPES | May 19, 2022 |
| Certified by provider | May 19, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Emergency Medicine Primary | 207P00000X | 12811005-1204 | UT |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Emergency Medicine (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 223 |
|---|---|
| Services billed | 449 across 20 procedure codes |
| Paid by Medicare | $29,376 |
Part D prescriptions in 2024
| Prescriptions (claims) | 116 · 117 30-day fills |
|---|---|
| Patients | 75 |
| Total drug cost | $2,533 |
| Generic share | 95% of claims |
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Emergency Medicine |
Medical groups
- Ihc Health Services IncMurray, UT · 3,960 clinicians
- Utah Emergency PhysiciansSalt Lake City, UT · 157 clinicians
Hospital affiliations
- Intermountain Health Layton HospitalLayton, UT
- Intermountain Health McKay-Dee HospitalOgden, UT
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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