NPIMap

Individual provider Active NPI

Stacy Forbes, P.A.

  • Physician Assistant
  • Portsmouth, VA
National Provider Identifier
1295187839
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00806500 Issued in NJ
Practice address
3636 High St
Portsmouth, VA 23707-3236
Phone
(757) 398-2200
NPI assigned
Jul 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024314 NY
Physician Assistant 363A00000X 0110-005416 VA
Physician Assistant 363A00000X 5601012407 MI
Physician Assistant 363A00000X 25MP00806500 NJ Primary

Addresses

Primary practice location

3636 High St
Portsmouth, VA 23707-3236

Mailing address

9691 Hitchcock Rd
Disputanta, VA 23842-6402
Phone (919) 761-4342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY, NJ, MI, IN5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20161220000732 VA Practitioner - Physician Assistant 3375824923 Reassigns benefits to 3 organizations
I20200424000225 NY Practitioner - Physician Assistant 3375824923 Reassigns benefits to 5 organizations
I20240411002855 NJ Practitioner - Physician Assistant 3375824923 Reassigns benefits to 3 organizations
I20240515003635 MI Practitioner - Physician Assistant 3375824923 Reassigns benefits to 2 organizations
I20250213000810 IN Practitioner - Physician Assistant 3375824923 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012407MIMDPhysician Assistant
25MP00806500NJMDPhysician Assistant
024314NYMDPhysician Assistant
0110-005416VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2017 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2017 Accepting new patients

Locations

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

Interoperability endpoints

  • Direct secure messaging: sforbes196897@direct-guthrie.org

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1295187839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9691 HITCHCOCK RD",
            "city": "DISPUTANTA",
            "state": "VA",
            "postal_code": "238426402",
            "telephone_number": "919-761-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073236",
            "telephone_number": "757-398-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "STACY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024314",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-005416",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012407",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00806500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.