Individual provider Active NPI

Jennifer Funk, M.D.

  • Internal Medicine Physician
  • Burlingame, CA
National Provider Identifier
1063875821
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A158008 Issued in CA
Practice address
1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone
(650) 696-5400
NPI assigned
Mar 30, 2016
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A158008 CA Primary

Addresses

Primary practice location

1501 Trousdale Dr
Burlingame, CA 94010-4506

Mailing address

2001 Winward Way Ste 101
San Mateo, CA 94404-2499

Other practice location 1

450 Stanyan St
San Francisco, CA 94117-1019
Phone (415) 750-5955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200115001059 CA Practitioner - HospitalistPractitioner - Internal Medicine 5092140327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Hospitalist Associates IncGroup PAC ID 3274780689, 38 clinicians

Practice addresses (Care Compare)

1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone (650) 696-3520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A158008CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Hospitalist Associates, Inc. Internal Medicine CurrentSince Dec 16, 2019 Accepting new patients

Locations

1501 Trousdale Dr
Burlingame, CA 94010
Phone (650) 696-3520

2001 Winward Way
Ste 101
San Mateo, CA 94404
Phone (650) 288-0602

Interoperability endpoints

  • Direct secure messaging: jfunk541439@hisp.ehr.sutterhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1063875821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 WINWARD WAY STE 101",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944042499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TROUSDALE DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104506",
            "telephone_number": "650-696-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Stanyan St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941171019",
            "country_code": "US",
            "telephone_number": "415-750-5955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNK",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A158008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.