Funcde, LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

FUNCDE, LLC

Doing business as

Functional Endocrinology

Practice address

969 Reading Rd Ste N
Mason, OH 45040

Phone

(513) 604-1004

Fax

(513) 437-0571

NPI assigned

Jun 18, 2017

Organization subpart

No

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

Authorized official

Name

Naila M Goldenberg, MDNPI 1396796330

Title

Practice Owner

Phone

(513) 604-1004

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Functional Endocrinology Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Naila M Goldenberg, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Mason, OH
  • NPI 1396796330
  Medicare reassignment Care Compare group Authorized official
• Michael Spivak, APRN, CNP

  • Family Nurse Practitioner
  • Mason, OH
  • NPI 1437499076
  Medicare reassignment Care Compare group
• Teaera L Roland, APRN, CNP

  • Family Nurse Practitioner
  • Liberty TWP, OH
  • NPI 1114468261

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1487184800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 READING RD STE N",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450402654",
            "telephone_number": "513-604-1004",
            "fax_number": "513-437-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 READING RD STE N",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-604-1004",
            "fax_number": "513-437-0571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Landmark Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "KY",
            "postal_code": "410731393",
            "country_code": "US",
            "telephone_number": "513-604-1004",
            "fax_number": "513-437-0571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FUNCDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "GOLDENBERG",
        "authorized_official_first_name": "NAILA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "513-604-1004",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079958",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0233942",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100510650",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Functional Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endocrinology, Diabetes & Metabolism Physician in Mason, OH
• Providers in Mason, OH by specialty
• Endocrinology, Diabetes & Metabolism Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.