Individual provider Active NPI

David K Funt, MD

  • Specialist
  • Woodmere, NY
National Provider Identifier
1295802940
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
145631 Issued in NY
Practice address
19 Irving PL
Woodmere, NY 11598-1229
Phone
(516) 295-0404
Fax
(516) 295-2440
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 145631 NY Primary

Addresses

Primary practice location

19 Irving PL
Woodmere, NY 11598-1229

Mailing address

19 Irving Place
Woodmere, NY 11598-1229
Phone (516) 295-0404

Other identifiers 1

IdentifierTypeStateIssuer
112974186OtherNYTAX ID

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
I20110531000204 NY Practitioner - Plastic and Reconstructive Surgery 9537346531 Practice locations: Woodmere, NY

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
George Washington University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 Irving PL
Woodmere, NY 11598-1229
Phone (201) 653-3203

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145631NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1295802940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 IRVING PLACE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981229",
            "telephone_number": "516-295-0404",
            "fax_number": "516-295-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 IRVING PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981229",
            "telephone_number": "516-295-0404",
            "fax_number": "516-295-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNT",
        "first_name": "DAVID",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "145631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "112974186",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, NY

Sources for this page

Verify at the official NPI Registry.