Individual provider Active NPI

Allen Fung, DPM

  • Primary Podiatric Medicine Podiatrist
  • Staten Island, NY
National Provider Identifier
1093150153
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
006673 Issued in NY
Practice address
827 Forest Ave
Staten Island, NY 10310-2410
Phone
(347) 977-4676
NPI assigned
May 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine Podiatrist 213ES0000X 006673 NY
Radiology Podiatrist 213ER0200X 006673 NY
Foot & Ankle Surgery Podiatrist 213ES0103X 006673 NY
Primary Podiatric Medicine Podiatrist 213EP1101X 006673 NY Primary

Addresses

Primary practice location

827 Forest Ave
Staten Island, NY 10310-2410

Mailing address

827 Forest Ave
Staten Island, NY 10310-2410
Phone (718) 981-5098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200210000930 NY Practitioner - Podiatry 2961838057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-6902

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue432
Removal of skin lesions33
Removal of nail tissue1066
Removal or shaving of skin growth412
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006673NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 10, 2025 Accepting new patients
Craig J Campbell DPM PC Primary Podiatric Medicine CurrentSince Dec 12, 2019 Accepting new patients
North Shore - Lij Medical PC CurrentSince Feb 10, 2025 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

1460 Victory Blvd
Staten Island, NY 10301
Phone (718) 273-8100

827 Forest Ave
Staten Island, NY 10310
Phone (718) 258-3379

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: afung69120@northwell.direct-ci.com

Organizations & group practices 3

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

Hospital & facility affiliations 3

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1093150153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102410",
            "telephone_number": "718-981-5098",
            "fax_number": "718-981-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102410",
            "telephone_number": "347-977-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NY",
            "license": "006673",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "NY",
            "license": "006673",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006673",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "006673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.