Mervyn B. Forman, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

035873 Issued in GA

Practice address

975 Johnson Ferry Rd NE
Ste 340
Atlanta, GA 30342-1619

Phone

(404) 256-0121

Fax

(404) 843-0355

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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.

• Mervyn B Forman MD, L.L.C

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1912165382

  GA

  Medicare reassignment Authorized official
• Cardiology of Atlanta

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1497941991
  Care Compare group
• SS OB GYN, PA

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
  • NPI 1093748725
  NPD (past)

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

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079

  Hospital

  Care Compare affiliation

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cardiology of Atlanta 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 17, 2008.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1215027461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FERRY RD NE",
            "address_2": "STE 340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421619",
            "telephone_number": "404-256-0121",
            "fax_number": "404-843-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FERRY RD NE",
            "address_2": "STE 340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421619",
            "telephone_number": "404-256-0121",
            "fax_number": "404-843-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MERVYN",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "035873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000526446D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Ellen Forhan, MD
• Caitlin Forkin
• Anna Forman, NP-C
• Ashley Erinn Forman, PMHNP
• Errol Forman, D.M.D.
• Alfred Fornah, CSCM
• Virginia Rutledge Forney, M.D.
• Kathleen Cleary Forrest
• Raven Danielle Forrest
• Ashlee Forrester

• All providers in Atlanta, GA
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.