Active NPI
Magdiel Lenin Fuentes Funez, PA-C
- Physician Assistant
- Englewood, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00577200
- Practice address
- 350 Engle St FL 5
Englewood, NJ 07631-1808 - Phone
- (201) 894-3636
- NPI assigned
- Jun 20, 2017
- Last updated
- Jan 3, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00577200 | NJ | Primary |
| Medical Physician Assistant | 363AM0700X | PA54487 | CA | |
| Surgical Physician Assistant | 363AS0400X | 3083 | SC | |
| Surgical Physician Assistant | 363AS0400X | 25MP00577200 | NJ | |
| Surgical Physician Assistant | 363AS0400X | PA54487 | CA |
Addresses
Primary practice location
350 Engle St FL 5
Englewood, NJ 07631-1808
Mailing address
331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877
Other practice location 1
171 Ashley Ave
Charleston, SC 29425-2186
Phone (843) 792-1414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0977721 | Medicaid | NJ |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Maf225@musc.edu | ||
| Direct Messaging Address | Maf225@musc.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391
20 Prospect Ave
Hackensack, NJ 07601-1997
30 Prospect Ave
Hackensack, NJ 07601-1915
4 Valley Health PLZ
Paramus, NJ 07652-3619
Phone (800) 825-5391
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.33 of 100
- Quality
- 66.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.39
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54487 | CA | MD | Dentist |
| PA54487 | CA | MD | Surgical Physician Assistant |
| 25MP00577200 | NJ | MD | Surgical Physician Assistant |
| 3083 | SC | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHJHBD
- maf225@musc.edu
- mfuentesfunez549157@direct.ahsys.org
Organizations & group practices 4
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.
-
dba HMHMG Specialty Care
- Surgical Critical Care Physician
- Red Bank, NJ
- NPI 1215989249
-
- Internal Medicine Physician
- Paramus, NJ
- NPI 1467815928
-
- Internal Medicine Physician
- Englewood, NJ
- NPI 1952681918
-
dba HMMG New Jersey Oral & Maxillofacial Surgery
- Durable Medical Equipment & Medical Supplies
- North Bergen, NJ
- NPI 1215734199
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Hackensack University Medical Center
- General Acute Care Hospital
- Hackensack, NJ
- NPI 1457456279
-
dba Hackensack Meridian Diagnostic Laboratory
- Clinical Medical Laboratory
- Hackensack, NJ
- NPI 1518683929
Hospital
-
- General Acute Care Hospital
- Paramus, NJ
- NPI 1013912633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1467972612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 NEWMAN SPRINGS RD STE 220",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077015792",
"telephone_number": "732-807-0877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 ENGLE ST FL 5",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076311808",
"telephone_number": "201-894-3636"
}
],
"practiceLocations": [
{
"address_1": "171 Ashley Ave",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294252186",
"country_code": "US",
"telephone_number": "843-792-1414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FUENTES FUNEZ",
"first_name": "MAGDIEL",
"middle_name": "LENIN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-20",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00577200",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA54487",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "SC",
"license": "3083",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NJ",
"license": "25MP00577200",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "PA54487",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0977721",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Maf225@musc.edu",
"affiliation": "N",
"address_1": "171 Ashley Ave",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "294252186",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Maf225@musc.edu",
"affiliation": "N",
"address_1": "171 Ashley Ave",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "294252186",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Englewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.