Forward Care Family Practice, PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

FORWARD CARE FAMILY PRACTICE, PLLC

Practice address

7800 N 55TH Ave
Glendale, AZ 85301-1321

Phone

(602) 373-8968

NPI assigned

Oct 23, 2020

Last updated

Oct 26, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ellana DavidovNPI 1538614672

Title

Authorized Official/Owner

Phone

(602) 373-8968

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22605/brand/1/csg/1/fhir/r4

Practitioners 7

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.

• Ellana Davidov, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1538614672
  Medicare reassignment Care Compare group Authorized official
• Nasser Hajaig, MD

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1457324204
  Medicare reassignment Care Compare group NPD
• Troy Lance Passmore, FNP-C

  • Family Nurse Practitioner
  • Surprise, AZ
  • NPI 1528561016
  Medicare reassignment NPD
• Julietta Rachel Shapiro, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1356824114
  Medicare reassignment
• Elizabeth Marie Tarufelli, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Mayer, AZ
  • NPI 1336162866
  NPD
• Nicole Marie Reyes, PA

  • Medical Physician Assistant
  • Queen Creek, AZ
  • NPI 1548410368
  NPD (past)
• Bikramjit Singh Nanar, MD

  • Family Medicine Physician
  • Henderson, NV
  • NPI 1013425255
  NPD (past)

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1205435880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 W WOBURN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850855031",
            "telephone_number": "602-373-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 N 55TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853011321",
            "telephone_number": "602-373-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORWARD CARE FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "DAVIDOV",
        "authorized_official_first_name": "ELLANA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OWNER",
        "authorized_official_telephone_number": "602-373-8968",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva Beatrix Forney
• Brandon Eugene Fornwalt
• Christina Forrey
• Adrienne W Forstner-Barthell, MD
• Cliff R Fortunat, PTA
• Jonathan D Fosbre, NP-C
• Kimberly Brook Foss
• Kristen Foster
• Sarah Katherine Foster, OTR/L
• Shirley Foster

• Physician Assistant in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.