Rosha Nicole Forman, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

RN271728 Issued in MA

Practice address

850 Harrison Ave
Yacc 4
Boston, MA 02118-4001

Phone

(617) 414-2000

Fax

(617) 414-5798

NPI assigned

Sep 30, 2008

Last updated

Apr 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rforman10301@direct.bmc.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boston University Obstetrics and Gynecology Foundation, Inc.

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1063459568
  Medicare reassignment NPD
• Codman Square Health Center Inc

  • Community Health Clinic/Center
  • Dorchester Center, MA
  • NPI 1396808309
  Medicare reassignment NPD
• Dothouse Health Inc.

  dba DotHouse Health

  • Community Health Clinic/Center
  • Dorchester, MA
  • NPI 1578514733
  Medicare reassignment NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD
• Child Health Foundation of Boston, Inc.

  • Pediatrics Physician
  • Boston, MA
  • NPI 1619969920
  NPD (past)

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1265683932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YACC 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "637 Washington St",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021243510",
            "country_code": "US",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "ROSHA",
        "middle_name": "NICOLE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "271728",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN271728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110086179A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Beth Forman, MD
• Ellen Forman
• John P Forman, MD
• Malka Leah Forman
• Meredith Silbana Forman, RRT
• Sara F Forman, MD
• Stuart A Forman, MD PHD
• Anna Formanek
• Arthur Raymond Formanek III, MD
• Cintia Fornasaro

• Advanced Practice Midwife in Boston, MA
• Providers in Boston, MA by specialty
• Advanced Practice Midwife in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.