NPIMap

Organization Active NPI

Forme Medical Center, Inc.

Doing business as Forme Urgent Care and Wellness Center

  • Clinic/Center
  • White Plains, NY
National Provider Identifier
1083755920
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5947200R Issued in NY
Legal business name
FORME MEDICAL CENTER, INC.
Doing business as
Forme Urgent Care and Wellness Center
Practice address
7-11 S Broadway Ste 100
White Plains, NY 10601-3520
Phone
(914) 723-4900
Fax
(914) 448-5275
NPI assigned
Feb 12, 2007
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Ms. Gina Cappelli
Title
President
Phone
(914) 723-4900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 5947200R NY Primary
Rehabilitation Clinic/Center 261QR0400X 5947200R NY
Special Hospital 284300000X 5947200R NY

Addresses

Primary practice location

7-11 S Broadway Ste 100
White Plains, NY 10601-3520

Mailing address

7-11 S Broadway Ste 100
White Plains, NY 10601-3520
Phone (914) 723-4900

Other identifiers 5

IdentifierTypeStateIssuer
5C7019OtherNYHEALTH NET PROVIDER
131056POtherNYHIP HEALTHPLAN PROVIDER
02087823MedicaidNY
A2204263OtherNYOXFORD PROVIDER
23901OtherNYCIGNA

Other names 1

  • Forme Urgent Care and Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160629002478 NY Part B Supplier - Clinic/Group Practice 5294899753 Receives reassigned benefits from 9 practitioners
Practice locations: White Plains, NY

National Provider Directory

National Provider Directory

Locations

1075 Central Park Ave
Ste 302
Scarsdale, NY 10583
Phone (914) 345-8605

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1083755920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7-11 S BROADWAY STE 100",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106013520",
            "telephone_number": "914-723-4900",
            "fax_number": "914-902-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7-11 S BROADWAY STE 100",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106013520",
            "telephone_number": "914-723-4900",
            "fax_number": "914-448-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORME MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "CAPPELLI",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-723-4900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "5947200R",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NY",
            "license": "5947200R",
            "primary": false
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "NY",
            "license": "5947200R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET PROVIDER",
            "identifier": "5C7019",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP HEALTHPLAN PROVIDER",
            "identifier": "131056P",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02087823",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER",
            "identifier": "A2204263",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "23901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forme Urgent Care and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.