Sam Fuller, MD
Sam Fuller, MD is a Plastic and Reconstructive Surgery Physician in South Bend, IN, registered under NPI 1649569484. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 53880 CARMICHAEL DR, South Bend, IN 46635. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 01075560A | IN | Plastic and Reconstructive Surgery… primary |
| 01075560A | IN | Surgery of the Hand (Surgery) Physician |
This provider holds licence 01075560A issued in IN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Hand Surgery
- PAC ID
- 4880989847
Medicare enrolment is recorded as approved under the provider type Practitioner - Hand Surgery. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Plastic and Reconstructive Surgery covers
A surgeon who specializes in plastic and reconstructive surgery. NUCC Health Care Provider Taxonomy, code 2086S0122X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2086S0122X | Plastic and Reconstructive Surgery Physician Plastic and Reconstructive Surgery | 01075560A | IN | primary |
| 2086S0105X | Surgery of the Hand (Surgery) Physician Surgery of the Hand | 01075560A | IN |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1649569484 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Apr 1, 2011 |
| Last updated | Sep 3, 2024 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
53880 CARMICHAEL DR South Bend, IN 46635 (574) 247-9441 Fax (574) 247-9442 |
| Mailing address |
3600 W BETHEL AVE Muncie, IN 47304 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 4 | 9 | 5 | 6 | 9 | 4 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 8 | 9 | 1 | 6 | 9 | 4 | 7 |
Sum = 76 · next multiple of 10 = 80 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.