Justin Wayne Fuller
NPI 1962176917ActiveIndividual· Nurse Anesthetist, Certified Registered· Goodyear, AZ
Nurse Anesthetist, Certified Registered with Banner Hospital Based Physicians Arizona LLC, practicing in Goodyear, Arizona. Medicare paid $6,961 for services to 63 patients in 2024. Merck Sharp & Dohme LLC reported $22.12 in payments in 2024, mostly food and beverage. Lists Banner Desert Medical Center as a hospital affiliation.
Overview
| NPI | 1962176917 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Aug 3, 2021 |
| Last updated in NPPES | Oct 15, 2026 |
| Certified by provider | Oct 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 264564 | AZ |
| Nurse Anesthetist, Certified Registered | 367500000X | RN185391 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (AZ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 63 |
|---|---|
| Services billed | 66 across 25 procedure codes |
| Paid by Medicare | $6,961 |
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Banner Hospital Based Physicians Arizona LLCGlendale, AZ · 637 clinicians
Hospital affiliation
- Banner Desert Medical CenterMesa, AZ
Industry payments (Open Payments)
- 2024$22.12 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Merck Sharp & Dohme LLC | $22.12 | 1 |
What the 2024 payments were for
- Food and Beverage$22.12 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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