Individual provider Active NPI

Ryan David Forster, M.D.

  • Pediatrics Physician
  • Bloomfield Hills, MI
National Provider Identifier
1184854564
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P3530 Issued in TX
Practice address
43205 Woodward
Bloomfield Hills, MI 48302-5006
Phone
(248) 451-0600
Fax
(248) 451-0700
NPI assigned
Jul 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P3530 TX Primary

Addresses

Primary practice location

43205 Woodward
Bloomfield Hills, MI 48302-5006

Mailing address

43205 Woodward
Bloomfield Hills, MI 48302-5006
Phone (248) 451-0600

Other identifiers 3

IdentifierTypeStateIssuer
301930901MedicaidTX
75-2616977-113OtherTXTRICARE
8HD986OtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120918000253 TX Practitioner - Pediatric Medicine 7719135649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P3530TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hopkins County Hospital District Current Accepting new patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Jun 1, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jun 1, 2017 Accepting new patients
Northeast Pediatric Associates, P.C. Pediatrics Past Accepting new patients
Maureen a Kelly MD PLLC PastSince Jan 17, 2021 Accepting new patients

Locations

105 Medical Plz
Sulphur Springs, TX 75482
Phone (903) 885-3181

113 Airport Rd
Ste 200
Sulphur Springs, TX 75482
Phone (903) 439-2273

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: ryanf@direct.hcmh.md

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1184854564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43205 WOODWARD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025006",
            "telephone_number": "248-451-0600",
            "fax_number": "248-451-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43205 WOODWARD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025006",
            "telephone_number": "248-451-0600",
            "fax_number": "248-451-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSTER",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P3530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301930901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-113",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8HD986",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.