Individual provider Active NPI

Wendell Lavern Funk, MD

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Lancaster, PA
National Provider Identifier
1326151499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
MD019811-E Issued in PA
Practice address
230 Harrisburg Ave
Suite 7
Lancaster, PA 17603-2959
Phone
(717) 299-9551
Fax
(717) 399-9266
NPI assigned
Aug 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X MD019811-E PA Primary

Addresses

Primary practice location

230 Harrisburg Ave
Suite 7
Lancaster, PA 17603-2959

Mailing address

230 Harrisburg Ave
Suite 7
Lancaster, PA 17603-2959
Phone (717) 299-9551

Other identifiers 1

IdentifierTypeStateIssuer
0812284MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110615000192 PA Practitioner - Plastic and Reconstructive Surgery 8729265921 Practice locations: Camp Hill, PA; Lancaster, PA; York, PA

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Temple University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 Grandview Ave
Suite 4
Camp Hill, PA 17011-1708
Phone (717) 763-5500

230 Harrisburg Ave
Suite 7
Lancaster, PA 17603-2959

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision31
Removal or shaving of skin growth15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD019811-EPAMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician

Hospital & facility affiliations 7

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326151499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HARRISBURG AVE",
            "address_2": "SUITE 7",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032959",
            "telephone_number": "717-299-9551",
            "fax_number": "717-399-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HARRISBURG AVE",
            "address_2": "SUITE 7",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032959",
            "telephone_number": "717-299-9551",
            "fax_number": "717-399-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "WENDELL",
        "middle_name": "LAVERN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "PA",
            "license": "MD019811-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0812284",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.