Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Michael Keen Fullar, MD

Individual provider Psychiatry Physician · NPI 1487711966

Mr. Michael Keen Fullar, MD is a Psychiatry in New York, New York. Qualified in 2003, 23 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
23
Licensed in
NY
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Partly verified

Some contact details are missing from the federal record.

Beth Israel Medical Center 1st Ave And 16th St
New York, NY 10003
Phone: (212) 844-1543
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 241619-1 (NY)

Record details

NPI number1487711966
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 3, 2007
Last updated in NPPESDecember 20, 2021
Certification dateDecember 20, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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