Active NPI
Christina Bungo, D.O.
- Geriatric Medicine (Family Medicine) Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- A-2388-20
- Practice address
- 4500 San Pablo Rd S
Jacksonville, FL 32224-1865 - Phone
- (904) 953-2000
- NPI assigned
- May 3, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | A-2388-20 | NM | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | UO 3532 | FL |
Addresses
Primary practice location
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Mailing address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Geriatric Medicine
- Education
- Lake Erie College of Osteopathic Medicine, Bradenton, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8800 Montgomery Blvd NE
Albuquerque, NM 87111-2310
Phone (505) 462-6400
Hospital & facility affiliations
- Presbyterian Home Healthcare
- Presbyterian Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.68 of 100
- Quality
- 82.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.6
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO 3532 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Past | Accepting new patients |
Locations
8800 Montgomery Blvd NE
Albuquerque, NM 87111
Phone (505) 462-6400
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
Interoperability endpoints
- cbungo181508@direct.phs.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Rural Acute Care Hospital
- Espanola, NM
- NPI 1154307593
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Psychiatric Hospital Unit
- Albuquerque, NM
- NPI 1598740482
-
- Home Health Agency
- Albuquerque, NM
- NPI 1881670214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1831534874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUNGO",
"first_name": "CHRISTINA",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-03",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "NM",
"license": "A-2388-20",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "UO 3532",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.