Individual provider Active NPI

Douglas Lee Forman, M.D.

  • Specialist
  • North Bethesda, MD
National Provider Identifier
1013955236
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0052044 Issued in MD
Practice address
11210 Old Georgetown Rd
North Bethesda, MD 20852-3202
Phone
(301) 881-7770
Fax
(301) 984-8601
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0052044 MD Primary

Addresses

Primary practice location

11210 Old Georgetown Rd
North Bethesda, MD 20852-3202

Mailing address

11210 Old Georgetown Rd
North Bethesda, MD 20852-3202
Phone (301) 881-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050121000583 DC Practitioner - Plastic and Reconstructive Surgery 1254380702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Perelman School of Med at the University of Pennsylvania, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friedman Forman and Associates MD PCGroup PAC ID 0547219099, 3 clinicians

Practice addresses (Care Compare)

11210 Old Georgetown Rd
North Bethesda, MD 20852-3202
Phone (301) 881-7770

Hospital & facility affiliations

  • Sibley Memorial Hospital Hospital, Washington, DC, CCN 090005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy16
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgery Institute of Washington, P.C. CurrentSince Sep 1, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

6035 Burke Centre Pkwy
Ste 390
Burke, VA 22015
Phone (703) 978-0756

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1013955236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11210 OLD GEORGETOWN RD",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523202",
            "telephone_number": "301-881-7770",
            "fax_number": "301-984-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11210 OLD GEORGETOWN RD",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523202",
            "telephone_number": "301-881-7770",
            "fax_number": "301-984-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "DOUGLAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0052044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bethesda, MD

Sources for this page

Verify at the official NPI Registry.