DR. MICHAEL J CUNNINGHAM M.D.
NPI 1033256243
Orthopaedic Surgery in Holmdel, NJ

Q: What is Michael Cunningham's NPI number?

The NPI number for Michael Cunningham is 1033256243. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Q: What is Michael Cunningham's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Active since January 30, 2007PECOS EnrolledAccepts Medicare Assignment

0/100

CMS Quality Rating

733 N BEERS ST, SUITE L-3, HOLMDEL, NJ 07733(732) 264-5454(732) 264-2043 Get Directions Write a Review

NPPES record last updated: March 11, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Michael J Cunningham M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL J CUNNINGHAM M.D. (NPI 1033256243) is an individual orthopaedic surgery provider in Holmdel, New Jersey, licensed in New Jersey (MA69669) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with St Joseph's University Medical Center Inc, and is a graduate of New York University School Of Medicine (1985).

NPPES Registry Identity

NPI1033256243

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. MICHAEL J CUNNINGHAMCredential: M.D.

Location Address733 N BEERS ST, SUITE L-3Holmdel, NJ 07733-1528

Mailing Address733 N Beers St, Suite L-3Holmdel, NJ 07733-1528 · (732) 264-5454 · Fax (732) 264-2043

Phone(732) 264-5454

Fax(732) 264-2043

Sole ProprietorYes

Medical School CMSNew York University School Of MedicineGraduated 1985

Enumeration DateJanuary 30, 2007

Last NPPES UpdateMarch 11, 2010

✔ NPI 1033256243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in NJ · MA69669

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

733 N BEERS ST, Holmdel, NJ 07733

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Other Identifiers 1

Medicare UPING14217NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael J Cunningham M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466547377

PECOS Enrollment IDI20090617000498

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Michael Cunningham reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Advanced Wellness

6.8 mi

Chiropractor

17 N MAIN ST
Marlboro, NJ 07746

Reassigned Medicare billing, New Jersey enrollment
26 clinicians in this Medicare group

NPI 1326053273 (732) 431-2155

Hackensack Meridian Health Medical Group - Specialty Care PC

7.0 mi

Surgical Critical Care

331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
2,844 clinicians in this Medicare group

NPI 1215989249 (732) 807-0800

Suburban Orthopaedic Medical Center, LLC

26 mi

Physical Medicine & Rehabilitation

554 BLOOMFIELD AVE
Newark, NJ 07107

Reassigned Medicare billing, New Jersey enrollment
7 clinicians in this Medicare group

NPI 1861603748 (973) 483-2277

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

901 services170 patients

Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose J7324

Orthovisc is a treatment involving injections of a substance called hyaluronan into your joints. Hyaluronan is a natural substance in your joint fluid that aids in movement and reduces pain. The Orthovisc injections help replenish this substance, relieving joint pain.

643 services105 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

553 services245 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

443 services109 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

438 services274 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

377 services247 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

201 services201 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

169 services103 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

85 services69 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

33 services29 patients

Aspiration and/or injection of fluid from medium joint 20605

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

32 services21 patients

Aspiration and/or injection of fluid from small joint 20600

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

28 services18 patients

Injection of trigger points, 1-2 muscles 20552

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

25 services18 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

20 services12 patients

Removal of both knee cartilages using an endoscope 29880

This procedure, also known as bilateral knee arthroscopy, involves using a small camera (endoscope) to view and remove damaged cartilage from both knees. It's a minimally invasive surgery aimed at relieving pain and improving mobility.

14 services14 patients

Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99304

An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph's University Medical Center Inc

Acute Care Hospitals · Paterson, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number310019

Location703 Main StPaterson, NJ 07503 · Passaic County

Birthing friendly

Raritan Bay Medical Center

Acute Care Hospitals · Perth Amboy, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310039

Location530 New Brunswick AvePerth Amboy, NJ 08861 · Middlesex County

Emergency services Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310108

Location65 James StreetEdison, NJ 08820 · Middlesex County

Emergency services Birthing friendly

Bayshore Medical Center

Acute Care Hospitals · Holmdel, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310112

Location727 N Beers StHolmdel, NJ 07733 · Monmouth County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07733 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.90 typical visit price

range $61.59 – $185.05

Typical copayment $23.72 (range $15.39 – $46.26)

Most-billed visit code 99203

Established Patient

$76.45 typical visit price

range $20.08 – $150.98

Typical copayment $19.11 (range $5.02 – $37.74)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

0/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

90%1,072 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%3,284 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

12%1,651 patients1/55-star benchmark: 99%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

0%1,651 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JASON I STEINFELD MD

Ophthalmology

733 N BEERS ST, STE 04
HOLMDEL, NJ 07733

Monmouth County (732) 739-0707

CUNNINGHAM ORTHOPAEDICS LLC

Orthopaedic Surgery

733 N BEERS ST, SUITE L-3
HOLMDEL, NJ 07733

Monmouth County (732) 264-5454

ANTOUN ASSOCIATES, P.A.

Urology

733 N BEERS ST, SUITE L 6
HOLMDEL, NJ 07733

Monmouth County (732) 739-2200

MR. SAID A SAMRA MD

Specialist

733 N BEERS ST, SUITE U1
HOLMDEL, NJ 07733

Monmouth County (732) 739-2100

DR. ANDREA ENGEL M.D.

Anesthesiology

733 N BEERS ST, SUITE U4
HOLMDEL, NJ 07733

Monmouth County (732) 739-2757

STEPHANIE LYNN WAGNER RN

Registered Nurse (Plastic Surgery)

733 N BEERS ST
HOLMDEL, NJ 07733

Monmouth County (732) 739-2100

RAJA BARAKAT MD

Pediatrics (Adolescent Medicine)

733 N BEERS ST, SUITE L5
HOLMDEL, NJ 07733

Monmouth County (732) 739-2100

ANTHONY DETULIO M.D.

Internal Medicine

733 N BEERS ST, SUITE 3
HOLMDEL, NJ 07733

Monmouth County (732) 264-8484

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Cunningham's NPI number?

The NPI number for Michael Cunningham is 1033256243. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Where is Michael Cunningham located?

Michael Cunningham practices at 733 N Beers St Suite L-3, Holmdel, NJ 07733. The listed phone number is (732) 264-5454.

What is Michael Cunningham's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Michael Cunningham enrolled in Medicare?

Yes. Michael Cunningham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Michael Cunningham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Cunningham reassigns Medicare benefits to 3 organizations: Advanced Wellness (Marlboro, NJ), Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ) and Suburban Orthopaedic Medical Center, LLC (Newark, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Cunningham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Cunningham accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Michael Cunningham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michael Cunningham affiliated with any hospitals?

According to CMS data, Michael Cunningham is affiliated with St Joseph's University Medical Center Inc, Raritan Bay Medical Center, Jfk Medical Center and Bayshore Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Cunningham was last updated on March 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.