Jason Wesley Fornara, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1943 Issued in AZ

Practice address

199 S Candy LN
Suite #2
Cottonwood, AZ 86326-4183

Phone

(928) 634-2883

NPI assigned

Aug 22, 2013

Last updated

Aug 22, 2013By the provider in NPPES

Sex

Male

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 AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fornara Eye Center P.C.Group PAC ID 5890862445, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score

40 of 100Reported as individual

Quality

80

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fornara Eye Center P.C.

  • Optometrist
  • Cottonwood, AZ
  • NPI 1295938207
  Medicare reassignment Care Compare group NPD

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

• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  Care Compare affiliation
• Verde Valley Medical Center

  dba Northern Arizona Healthcare - Sedona

  • General Acute Care Hospital
  • Sedona, AZ
  • NPI 1538608716
  Care Compare affiliation

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1093149320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 S CANDY LN",
            "address_2": "SUITE #2",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264183",
            "telephone_number": "928-634-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 S CANDY LN",
            "address_2": "SUITE #2",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264183",
            "telephone_number": "928-634-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNARA",
        "first_name": "JASON",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph E Fernandez, AGPCNP-C
• Kathy Lynn Fisher, O.M.D.,ACUPUNCTURIST
• Timothy J Fitch, PA-C
• Forefront Dermatology SC (Arizona Dermatology Group, a Forefront Dermatology Practice)
• Fornara Eye Center P.C.
• John David Fornara, O.D.
• Irene Lynette Forrest, ARNP-C
• Founders Healthcare, LLC (Preferred Homecare)
• Dylan Frauhiger, DPT
• Fresenius Medical Care Cottonwood, LLC (Fresenius Kidney Care Cottonwood)

• Optometrist in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.