Individual provider Active NPI

Emily Kathryn Funk

  • Otolaryngology Physician
  • San Diego, CA
National Provider Identifier
1417480252
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD480835 Issued in PA
Practice address
200 W Arbor Dr
MC 8895
San Diego, CA 92103-9000
Phone
(619) 543-1967
Fax
(619) 543-5521
NPI assigned
Apr 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD480835 PA Primary

Addresses

Primary practice location

200 W Arbor Dr
MC 8895
San Diego, CA 92103-9000

Mailing address

925 Chestnut St FL 6
Philadelphia, PA 19107-4204
Phone (215) 955-6056

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
I20230802001245 PA Practitioner - Otolaryngology 7113388547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians

Practice addresses (Care Compare)

500 Universidy Dr
Hershey, PA 17033-2360
Phone (717) 531-8131

Hospital & facility affiliations

  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD480835PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group Otolaryngology CurrentSince Aug 26, 2024 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Jefferson University Physicians Otolaryngology CurrentSince Jul 1, 2023 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 26, 2024 Accepting new patients
The Milton S Hershey Medical Center Past Accepting new patients

Locations

500 University Dr
#A4
Hershey, PA 17033
Phone (717) 531-6261

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1491609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1417480252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST FL 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074204",
            "telephone_number": "215-955-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "MC 8895",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-1967",
            "fax_number": "619-543-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "EMILY",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-08",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD480835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.