Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Matthew Paul Fuller, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053030759

Matthew Paul Fuller, PA-C is a Student in an Organized Health Care Education/Training Program in Boston, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2022.

Licensed in
MA
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

55 Fruit St
Boston, MA 02114-2696
Phone: (617) 724-4100
Fax: (617) 726-7415
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA100048 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1053030759
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 25, 2022
Last updated in NPPESOctober 3, 2023
Certification dateOctober 3, 2023

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