DR. BOBGA S FOMUNUNG (MD) – Psychiatry Physician, NPI 1700899010
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,216 PSYCHIATRY in MI
Provider Addresses for DR. BOBGA S FOMUNUNG (MD)
1939, Division Avenue South, Grand Rapids, Kent County, Michigan, 49507, United States
GRAND RAPIDS, MI 49507
Phone: (616) 247-3815
Fax: (616) 245-0450
Type: Mailing
1281 Innisbrook Ct
Holland, MI 494235502
Phone: (616) 834-7279
Type: Location
1281 INNISBROOK CT
HOLLAND, MI 494235502
Phone: (616) 834-7279
Fax: (616) 245-0450
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 192 Open Payments records for all available years, with a total value of $3,399.
Total Amount is formed as General ($3,399) + Research ($0) + Ownership ($0) = $3,399.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($1,265).
Total Amount
$3,399
General + Research + Ownership
Payments
192
Total payment records
General Amount
$3,399
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $1,265 |
| Corium, LLC | $380 |
| Ironshore Pharmaceuticals Inc. | $292 |
| IRONSHORE PHARMACEUTICALS INC. | $218 |
| Teva Pharmaceuticals USA, Inc. | $142 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-12-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041207000420 | I | Psychiatry | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 45 | 22 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 25 | 14 | $0 |
Insurance plans in this area (ZIP 49507)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | MI | |
| Internal Medicine | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| P S Y C H I A T R Y | MI | |
| Family Practice | MI | |
| - | MI |
Reviews
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