Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Dr. Shandi Joycelyn Fuller , MD

Pediatrics β€’ Berkeley, CA

Active NPI 1225285034 Individual Practitioner Female Practitioner
Practice location in NPPES

1918 Bonita Ave Ste 200
Berkeley, CA 947041014

Call 5109391300 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1918 Bonita Ave Ste 200

Berkeley, CA 947041014

Telephone 5109391300
Organization at the Same NPPES Address or Phone
Psychosocial Therapy Licensed Marriage And Family Therapists Inc. Facility NPI 1134872971

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Fairfield, CA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Open Payments general payments, program year 2023

All general payments: $61.74 across 2 records.

By nature of payment

  • Food and Beverage: $61.74 across 2 records.

Reporting-company totals

  • GlaxoSmithKline, LLC.: $61.74 across 2 records.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2023 (published June 30, 2026).

Guide: How to read an Open Payments record

NPI first issued

2008

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Fuller has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Fuller as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Berkeley and California

51 active clinicians are listed under Pediatrics with a practice address in Berkeley, CA (9,280 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Berkeley

0% of these 51 clinicians have the CMS telehealth indicator.

3.9% of these 51 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2023), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2023
Disclosure Year:

Program year 2023 (payments made January 1 – December 31, 2023): fewer than 11 records totaling $61.74.

Manufacturer Payment Nature Product Type Amount ($)
GlaxoSmithKline, LLC.
Food and Beverage
In-kind items and services
BEXSERO General $31.85
GlaxoSmithKline, LLC.
Food and Beverage
In-kind items and services
BEXSERO General $29.89

Source: CMS Open Payments, program year 2023, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-06-14
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES CA A117119

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Certification
97347 (NC)
Other Identifier License
A117119 (CA)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20170731003570

Enrollment State Jurisdiction

CA

PECOS Control ID

7012074339

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

2201 Courage Dr

Fairfield, CA 945336733

Phone: 7077848348

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
πŸ“
Updated Practice Location June 14, 2022

Registered at 1918 BONITA AVE STE 200, BERKELEY, CA 947041014 (Tel: 5109391300)

πŸ“
Updated Business Mailing Address June 14, 2022

Registered at 1918 BONITA AVE STE 200, BERKELEY, CA 947041014 (Tel: 1059391300)

βœ…
NPI Profile Active July 19, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location July 19, 2017

Registered at 2201 COURAGE DR, FAIRFIELD, CA 945336733 (Tel: 7077848348)

πŸ“
Updated Business Mailing Address July 19, 2017

Registered at 2201 COURAGE DR, FAIRFIELD, CA 945336733 (Tel: 7077848348)

πŸ‘€
Provider Name / Credentials Updated July 19, 2017

Recorded as SHANDI FULLER, MD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2017

Pediatrics (license number reported to NPPES: CA A117119)

βœ…
NPI Profile Active July 08, 2011

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 08, 2011

Registered at 1 HOSPITAL RD, CHEROKEE, NC 28719 (Tel: 8284979163)

πŸ“
Business Mailing Address (Initial Record) July 08, 2011

Registered at 1 HOSPITAL RD, CHEROKEE, NC 28719 (Tel: 8284979163)

πŸ‘€
Provider Name / Credentials (Initial Record) July 08, 2011

Recorded as SHANDI FULLER, MD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2011

Pediatrics (license number reported to NPPES: NC 2008-00622)

🟒
Initial NPI Registration & Enumeration August 22, 2008

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1225285034
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 22, 2008
Last Update: June 14, 2022
Sole Proprietor: No

Other Pediatrics Specialists in Berkeley

Healthcare providers in Berkeley

Mailing Address

1918 Bonita Ave Ste 200

Berkeley, CA 947041014

Phone: 1059391300

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.