Active NPI
Michael Fung, MBCHB
- Sports Medicine (Family Medicine) Physician
- Buffalo, NY
National Provider Identifier
1972647386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 002696-1
- Practice address
- 3435 Main St
160 Farber Hall
Buffalo, NY 14214-3001 - Phone
- (716) 829-2070
- NPI assigned
- Feb 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 002696-1 | NY | Primary |
Addresses
Primary practice location
3435 Main St
160 Farber Hall
Buffalo, NY 14214-3001
Mailing address
95 Spring Meadow Dr
Apt 19
Williamsville, NY 14221-8415
Phone (716) 632-6002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002696-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972647386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 SPRING MEADOW DR",
"address_2": "APT 19",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142218415",
"telephone_number": "716-632-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3435 MAIN ST",
"address_2": "160 FARBER HALL",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142143001",
"telephone_number": "716-829-2070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNG",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MBCHB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "NY",
"license": "002696-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.