Individual provider Active NPI

Martha E Funkhouser, M.D.

  • Dermatology Physician
  • Princeton, NJ
National Provider Identifier
1235195157
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA06040900 Issued in NJ
Practice address
208 Bunn Dr
Princeton, NJ 08540-2851
Phone
(609) 683-4999
NPI assigned
Apr 21, 2006
Last updated
Feb 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA06040900 NJ Primary

Addresses

Primary practice location

208 Bunn Dr
Princeton, NJ 08540-2851

Mailing address

208 Bunn Dr
Princeton, NJ 08540-2851
Phone (609) 683-4999

Other identifiers 1

IdentifierTypeStateIssuer
223777703OtherNJCOMMERCIAL INSURANCES

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
I20111013000394 CA Practitioner - Dermatology 6709918865 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Minnesota Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

22 W 39TH Ave
Hos316Ms
San Mateo, CA 94403-4364

222 W 39TH Ave
San Mateo, CA 94403-4364

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Dermatology Current Accepting new patients
Alameda Health System CurrentSince Jan 31, 2018 Accepting new patients
Alameda Health System CurrentSince Jan 31, 2018 Accepting new patients
Permanente Medical Group, Inc CurrentSince Sep 9, 2017 Accepting new patients
County of San Mateo CurrentSince Sep 23, 2017 Accepting new patients
Permanente Medical Group Inc Dermatology CurrentSince Sep 9, 2017 Accepting new patients
County of San Mateo CurrentSince Sep 23, 2017 Accepting new patients
Alameda Health System Current Accepting new patients
County of San Mateo CurrentSince Sep 23, 2017 Accepting new patients
Princeton Dermatology Associates Kendall Parkpc Dermatology Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

3701 Broadway
Oakland, CA 94611
Phone (510) 752-1244

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: mfunkhouser19718@smch.direct-ci.com

Organizations & group practices 10

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 8

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1235195157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BUNN DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402851",
            "telephone_number": "609-683-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 BUNN DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402851",
            "telephone_number": "609-683-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNKHOUSER",
        "first_name": "MARTHA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA06040900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCES",
            "identifier": "223777703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.