Antonia Bih Fomunyam Nyongabsen

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4351049663 Issued in MI

Practice address

25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526

Phone

(616) 391-3777

NPI assigned

Apr 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Internal Medicine

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospice Hospice, Oklahoma City, OK, CCN 371509
• Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
• Oklahoma Heart Hospital, LLC Hospital, Oklahoma City, OK, CCN 370215

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  NPD (past)

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

• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  Care Compare affiliation
• Mercy Hospital Oklahoma City, Inc.

  • Community Based Hospice Care Agency
  • Oklahoma City, OK
  • NPI 1487748646
  Care Compare affiliation
• Oklahoma Heart Hospital, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1083617005
  Care Compare affiliation

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1093456196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE STE 2100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032526",
            "telephone_number": "616-391-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE STE 2100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032526",
            "telephone_number": "616-391-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMUNYAM NYONGABSEN",
        "first_name": "ANTONIA",
        "middle_name": "BIH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351049663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Matthew Foley, D.O.
• Rachel Follenweider
• Kenneth David Follett III
• David Andrew Folt, M.D.
• Bobga S Fomunung, MD
• Christina Fong
• Gene Fonger, O.D.
• James Fongers, MSW, LMSW
• Katie Fontaine, PT, DPT
• Ryan K Fontanilla, MD

• Internal Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.

Verify at the official NPI Registry.