Gina M Formea

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001996 Issued in WA

Practice address

University of Washington Medical Ctr
1959 NE Pacific St
Seattle, WA 98195-6157

Phone

(206) 598-4295

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harborview Medical Center Hospital, Seattle, WA, CCN 500064

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as apm

Quality

74.6

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  Medicare reassignment Care Compare group NPD
• Harborview Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1053359729
  Medicare reassignment NPD
• Harborview Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1568557312
  NPD
• Kaleidoscope Counseling PLLC

  • Clinical Social Worker
  • Mukilteo, WA
  • NPI 1245093293
  NPD (past)

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

• Harborview Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1053359729
  Care Compare affiliation

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154464618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF WASHINGTON MEDICAL CTR",
            "address_2": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956157",
            "telephone_number": "206-598-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMEA",
        "first_name": "GINA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "4818",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forever Adult Family Home
• Forged Athlete PLLC
• Margaret Mary Forgette, MD
• Susanne Forhan, LMP
• Amahgene Forks, AAC
• Ellen Forney
• Lauren Forney
• Elizabeth Blessing Fornoff, RN
• Agnes Judith Forras, LMHC
• David Forrest, LPHD

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.