Forum Health Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FORUM HEALTH SERVICES, INC.

Practice address

12722 Riverside Dr Ste 207a
Valley Village, CA 91607-3326

Phone

(818) 570-2494

Fax

(818) 301-3697

NPI assigned

Jan 21, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Sergey Bedrossian

Title

Ceo

Phone

(818) 570-2494

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757653

Legal name

FORUM HEALTH SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 1, 2024

Last certification

Apr 23, 2024

Organization structure

CorporationProprietary

Incorporated

Jan 6, 2022 in CA

Enrollment address

12722 Riverside Dr
Ste 207a
Valley Village, CA 91607-3326

Listed as

Forum Health Services, IncCCN 757653

Ownership

-

Certified

May 1, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jon P Kea, M,D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1952551228

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1205588159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12722 RIVERSIDE DR STE 207A",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073326",
            "telephone_number": "818-570-2494",
            "fax_number": "818-301-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12722 RIVERSIDE DR STE 207A",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073326",
            "telephone_number": "818-570-2494",
            "fax_number": "818-301-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORUM HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "BEDROSSIAN",
        "authorized_official_first_name": "SERGEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-570-2494",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Response Home Health Inc
• Five Eighteen Inc
• Michael Fleming, PA
• Margaret Flynn, LICSW
• Fna Specialists of the Valley
• Mehdi Fotovat, DDS
• Kristopher Frontella
• Lindsey Eppy Frost, RDN
• G Murdock PHD a Psychological Corporation
• Yocheved Sara Gabay

• Home Health Agency in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.