Individual provider Active NPI

Maria Lourdes Bunag, MD

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1144287533
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1681611 Issued in NY
Practice address
1050 Clove Rd
Staten Island, NY 10301-3627
Phone
(718) 816-6440
Fax
(718) 816-3611
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1681611 NY Primary

Addresses

Primary practice location

1050 Clove Rd
Staten Island, NY 10301-3627

Mailing address

528 Ocean Ter
Staten Island, NY 10301-4522
Phone (718) 816-6440

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040611000190 NY Practitioner - Internal Medicine 1355324278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Targee St
Staten Island, NY 10304-4323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1681611NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Internal Medicine Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 1, 1992 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine CurrentSince Jan 1, 1992 Accepting new patients

Locations

50 Water St
Fl 3
New York, NY 10004

460 Brielle Ave
Staten Island, NY 10314
Phone (646) 694-6680

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144287533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 OCEAN TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014522",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013627",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNAG",
        "first_name": "MARIA",
        "middle_name": "LOURDES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1681611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.