Organization Active NPI

Philip D Fu MD PC

  • Internal Medicine Physician
  • Williamsville, NY
National Provider Identifier
1922298512
Registry record updated Nov 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PHILIP D FU MD PC
Practice address
6636 Main Street
Suite 1
Williamsville, NY 14221-5967
Phone
(716) 633-0541
Fax
(716) 633-0543
NPI assigned
Jul 30, 2007
Last updated
Nov 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2018

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

Authorized official

Name
Dr. Philip Fu, MDNPI 1285877050
Title
President
Phone
(716) 633-0541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

6636 Main Street
Suite 1
Williamsville, NY 14221-5967

Mailing address

6636 Main Street
Suite 1
Williamsville, NY 14221-5967
Phone (716) 633-0541

Other names 1

  • Cheng Shung Fu, M.D., P.C. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090122000632 NY Part B Supplier - Clinic/Group Practice 6800950627 Receives reassigned benefits from 3 practitioners
Practice locations: Williamsville, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0170244Philip D Fu MD PC6636 Main Street Ste 1, Williamsville, NY 14221Certificate of waiverMar 22, 2028

National Provider Directory

National Provider Directory

Locations

6636 Main St
Ste 1
Williamsville, NY 14221
Phone (716) 633-0541

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542844800000",
    "number": "1922298512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6636 MAIN STREET",
            "address_2": "SUITE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215967",
            "telephone_number": "716-633-0541",
            "fax_number": "716-633-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6636 MAIN STREET",
            "address_2": "SUITE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215967",
            "telephone_number": "716-633-0541",
            "fax_number": "716-633-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP D FU MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2018-11-22",
        "status": "A",
        "authorized_official_last_name": "FU",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-633-0541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cheng Shung Fu, M.D., P.C.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Cheng Shung Fu, M.D., P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.