NPIMap

Individual provider Active NPI

Eleanor C. Fung, M.D.

  • Surgery Physician
  • Tonawanda, NY
National Provider Identifier
1780078394
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
289393 Issued in NY
Practice address
1208 Niagara Falls Blvd
Tonawanda, NY 14150-8924
Phone
(716) 833-7112
Fax
(168) 337-1507
NPI assigned
Mar 20, 2015
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 289393 NY Primary

Addresses

Primary practice location

1208 Niagara Falls Blvd
Tonawanda, NY 14150-8924

Mailing address

PO Box 488
Buffalo, NY 14240-0488
Phone (203) 944-1940

Other identifiers 2

IdentifierTypeStateIssuer
0131541MedicaidOH
04848500MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171107002651 NY Practitioner - General Surgery 4981911484 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University at Buffalo Surgeons IncGroup PAC ID 4183612799, 40 clinicians
Kaleida HealthGroup PAC ID 7810805280, 214 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 568-3600

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 862-1000

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
80.2
Improvement activities
40
Cost
72.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux165
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
289393NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince Feb 18, 2018 Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
University at Buffalo Surgeons Inc Surgery CurrentSince Nov 1, 2017 Accepting new patients
Kaleida Health Current Accepting new patients
Kaleida Health CurrentSince Oct 1, 2017 Accepting new patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Erie County Medical Center Corporation CurrentSince Feb 18, 2018 Accepting new patients
Kaleida Health CurrentSince Oct 1, 2017 Accepting new patients
Kaleida Health Past Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

100 High St
#B2
Buffalo, NY 14203
Phone (716) 859-1256

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

111 N Maplemere Rd
Ste 170
Williamsville, NY 14221
Phone (716) 588-5086

111 N Maplemere Rd
Ste 150
Williamsville, NY 14221
Phone (716) 626-2644

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

215 Klein Rd
Williamsville, NY 14221
Phone (716) 568-6100

Interoperability endpoints

  • Direct secure messaging: eleanorfung@ubmd.allscriptsdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 10

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": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1780078394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142400488",
            "telephone_number": "203-944-1940",
            "fax_number": "203-916-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 NIAGARA FALLS BLVD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508924",
            "telephone_number": "716-833-7112",
            "fax_number": "168-337-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "ELEANOR",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-20",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "289393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0131541",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04848500",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.