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Individual provider Active NPI

Malena Forgach, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Durand, MI
National Provider Identifier
1104372358
Registry record updated Sep 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007879 Issued in MI
Practice address
9099 E Lansing Rd
Durand, MI 48429
Phone
(989) 288-0400
NPI assigned
Aug 28, 2016
Last updated
Sep 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007879 MI Primary

Addresses

Primary practice location

9099 E Lansing Rd
Durand, MI 48429

Mailing address

5947 Troyes Rd
East Lansing, MI 48823-9230
Phone (989) 430-1166

Other practice location 1

505 N Clippert St.
Lansing, MI 48912
Phone (517) 999-2273

Other practice location 2

505 N Clippert St.
Lansing, MI 48912
Phone (517) 999-2273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161117000946 MI Practitioner - Physician Assistant 6406135326 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-7700

2900 Hannah Blvd
Suite 216
East Lansing, MI 48823-5382
Phone (517) 364-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007879MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association CurrentSince Feb 1, 2023 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Feb 1, 2023 Accepting new patients
Memorial Hospital Physician Assistant CurrentSince Mar 1, 2018 Accepting new patients
Memorial Hospital CurrentSince Mar 1, 2018 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients
Mid-Michigan Physicians, PC Physician Assistant Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

9099 E Lansing Rd
Durand, MI 48429
Phone (989) 288-1800

2900 Hannah Blvd
Ste 216
East Lansing, MI 48823
Phone (517) 364-8001

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569715200000",
    "number": "1104372358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5947 TROYES RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488239230",
            "telephone_number": "989-430-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9099 E LANSING RD",
            "city": "DURAND",
            "state": "MI",
            "postal_code": "48429",
            "telephone_number": "989-288-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 N Clippert St.",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "48912",
            "country_code": "US",
            "telephone_number": "517-999-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 N Clippert St.",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "48912",
            "country_code": "US",
            "telephone_number": "517-999-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORGACH",
        "first_name": "MALENA",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2019-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durand, MI

Sources for this page

Verify at the official NPI Registry.