Tori Ellen Austin Forth, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9108460 Issued in FL

Practice address

200 N John Young Pkwy
Suite 203
Kissimmee, FL 34741-6601

Phone

(407) 624-3062

Fax

(407) 613-2223

NPI assigned

May 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Pediatrix Medical Group of Florida Inc

  • Pediatric Cardiology Physician
  • Sunrise, FL
  • NPI 1083711790
  Medicare reassignment
• Orlando Pediatric Pulmonary and Sleep Associates PA

  • Pediatric Pulmonology Physician
  • Winter Park, FL
  • NPI 1316010952
  NPD (past)

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1083093389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N JOHN YOUNG PKWY",
            "address_2": "SUITE 203",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416601",
            "telephone_number": "407-624-3062",
            "fax_number": "407-613-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N JOHN YOUNG PKWY",
            "address_2": "SUITE 203",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416601",
            "telephone_number": "407-624-3062",
            "fax_number": "407-613-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTH",
        "first_name": "TORI",
        "middle_name": "ELLEN AUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9108460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Fontanez
• Aalisah Yvette Forde
• Kim Forero
• Domenico Foresta I
• Edlyne D Fort
• Alexis Fortin
• Karen Fortuna, RN
• Nina Marie Fortuno Colon, MS-SLP-CFY
• Eluanelis Yanille Forty-Sanchez
• Sophia Fouche

• Surgical Physician Assistant in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.