Active NPI
Allen Fung, DPM
- Primary Podiatric Medicine Podiatrist
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- 006673
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
Practice addresses (Care Compare)
375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-6902
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 432 |
| Removal of skin lesions | 33 |
| Removal of nail tissue | 1066 |
| Removal or shaving of skin growth | 412 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006673 | NY | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Craig J Campbell DPM PC | Primary Podiatric Medicine | Current | Accepting new patients |
| North Shore - Lij Medical PC | Current | 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
- 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.
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Durable Medical Equipment & Medical Supplies
- Staten Island, NY
- NPI 1801067822
Primary Podiatric Medicine
-
dba NSLIJ Medical In Queens
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Manhasset, NY
- NPI 1417965278
-
- Home Health Agency
- Westbury, NY
- NPI 1861464471
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1407877137
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.