Lana Elizabeth Formo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8307 Issued in AZ

Practice address

4582 N 1St Ave Ste 170
Tucson, AZ 85718-8607

Phone

(520) 829-6776

Fax

(520) 829-6661

NPI assigned

Apr 10, 2020

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Institute of Southern Arizona Pisa PCGroup PAC ID 4688615362, 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.65 of 100Reported as group

Quality

76.23

Promoting interoperability

100

Improvement activities

40

Cost

75.95

Merit-based Incentive Payment System (MIPS)

Final score

45.68 of 100Reported as group

Quality

40.49

Promoting interoperability

0

Improvement activities

30

Cost

74.27

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72783

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.

• Pain Institute of Southern Arizona Pisa PC

  • Pain Medicine (Anesthesiology) Physician
  • Tucson, AZ
  • NPI 1861575078

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Center for Orthopedic Research and Education, LLC

  dba The CORE Institute

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1427095801

  Single Specialty

  Medicare reassignment NPD (past)
• Center for Orthopedic Research and Educatoin

  dba The CORE Institute

  • Physical Therapist
  • Mesa, AZ
  • NPI 1275967408
  NPD
• Pain Institute of Southern Arizona Pisa PC

  dba Regional Pain Institute

  • Pain Medicine (Anesthesiology) Physician
  • San Tan Valley, AZ
  • NPI 1780268912

  Single Specialty

  NPD

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1396364261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122704",
            "telephone_number": "520-829-6776",
            "fax_number": "520-829-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4582 N 1ST AVE STE 170",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857188607",
            "telephone_number": "520-829-6776",
            "fax_number": "520-829-6661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Dobson Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024724",
            "country_code": "US",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4881 E Grant Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122704",
            "country_code": "US",
            "telephone_number": "520-829-6776",
            "fax_number": "520-829-6661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMO",
        "first_name": "LANA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8307",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forever Able Acupuncture and Wellness Center (Forever Able Wellness)
• Forever Fabulous Permanent Cosmetics
• Margaret T Forgey, LCSW
• Aisha Forman
• Bonnie J Formentini
• Susan Lee Forno, MS
• Scott C Forrer, MD
• Skye Forrest, LPC
• Andre Wayne Forrester, FNP
• Sarah R Forrester, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.
• 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.