Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Ty Fullmer, DO

Individual provider Emergency Medicine Physician · NPI 1679136758

Ty Fullmer, DO practises Emergency Medicine in Clinton Township, Michigan. Qualified in 2019, 7 years ago. Practices with Utah Emergency Physicians, a 149-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
7
Licensed in
UT
In the registry since
2019
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone: (586) 263-2300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4401 Harrison Blvd, Ogden, UT 84403-3195 — (801) 387-7000

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 12811005-1204 (UT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1679136758
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 15, 2019
Last updated in NPPESMay 19, 2022
Certification dateMay 19, 2022

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Utah Emergency Physicians — 149 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients223
Services billed 449 a service is one billed item, such as a visit, a test or a procedure
Average patient age72

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Intermountain Health Layton Hospital Hospital · Layton, UT
  • Intermountain Health McKay-Dee Hospital Hospital · Ogden, UT

Colleagues at Utah Emergency Physicians

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 149 clinicians in the practice; 12 are shown here.

Other providers in Clinton Township