Gina Fundaro, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301074481 Issued in MI

Practice address

4100 John R St
Detroit, MI 48201-2013

Phone

(313) 745-8042

Fax

(313) 745-2314

NPI assigned

Oct 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Diagnostic Radiology

Education

Wayne State University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regional Medical Imaging PCGroup PAC ID 4688637697, 22 clinicians

Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilson Memorial Hospital Hospital, Sidney, OH, CCN 360013
• Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147
• Selby General Hospital Hospital, Marietta, OH, CCN 361319
• Knox Community Hospital Hospital, Mount Vernon, OH, CCN 360040
• Avita Ontario Hospital, Ontario, OH, CCN 360365

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Regional Medical Imaging, P.C.

  • Diagnostic Radiology Physician
  • Flint, MI
  • NPI 1427057967
  Medicare reassignment Care Compare group NPD
• Riverside Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1093718496

  MI

  Medicare reassignment Care Compare group NPD
• McKenzie Memorial Hospital

  • Critical Access Hospital
  • Sandusky, MI
  • NPI 1497750608
  Medicare reassignment NPD
• Radadvantage a Professional Corporation

  • Diagnostic Radiology Physician
  • Phoenix, AZ
  • NPI 1376719666

  MI

  Medicare reassignment NPD
• McKenzie Memorial Hospital

  • Rural Health Clinic/Center
  • Peck, MI
  • NPI 1437917598
  NPD
• Barbara Ann Karmanos Cancer Institute

  • Mammography Clinic/Center
  • Detroit, MI
  • NPI 1225022288
  NPD (past)
• Barbara Ann Karmanos Cancer Institute

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Detroit, MI
  • NPI 1386060226
  NPD (past)
• Family Orthopedic Associates P L C

  • Physical Therapist
  • Flint, MI
  • NPI 1326436817
  NPD (past)

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

• Avita Ontario Hospital

  • General Acute Care Hospital
  • Ontario, OH
  • NPI 1790131050
  Care Compare affiliation
• Knox Community Hospital

  • General Acute Care Hospital
  • Mount Vernon, OH
  • NPI 1295761963
  Care Compare affiliation
• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1215936927
  Care Compare affiliation
• Selby General Hospital

  • Critical Access Hospital
  • Marietta, OH
  • NPI 1124073465
  Care Compare affiliation
• Shelby County Memorial Hospital Association Inc.

  • General Acute Care Hospital
  • Sidney, OH
  • NPI 1639174204
  Care Compare affiliation

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1275520512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24601 NORTHWESTERN HWY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752473",
            "telephone_number": "248-827-4580",
            "fax_number": "248-827-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "313-745-8042",
            "fax_number": "313-745-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDARO",
        "first_name": "GINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301074481",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301074481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7005261920",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Talena Fultz
• Fun Day Adult Day Care
• Keoshia Funches
• Functional Fluidics Inc
• Functional Fluidics LLC
• Gerald R. Funderburg Jr., NONE
• Brent Funk, PSY.D.
• Shardaya Fuquay
• Darlene Lashell Fussell
• Renee Fyfe, CPSS & CPRC

• Diagnostic Radiology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.