Organization Active NPI

Christine Forszpaniak Inc

  • Specialist
  • Naples, FL
National Provider Identifier
1396703369
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME 49793 Issued in FL
Legal business name
CHRISTINE FORSZPANIAK INC
Practice address
848 1St Ave N
Suite 230
Naples, FL 34102-6013
Phone
(239) 434-7779
Fax
(239) 434-7588
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Christine Forszpaniak, M.D.NPI 1841488111
Title
President
Phone
(239) 434-7779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME 49793 FL Primary

Addresses

Primary practice location

848 1St Ave N
Suite 230
Naples, FL 34102-6013

Mailing address

848 1St Ave N
Suite 230
Naples, FL 34102-6013
Phone (239) 434-7779

Other identifiers 4

IdentifierTypeStateIssuer
064785300MedicaidFL
110050893OtherFLRAIL ROAD MEDICARE
DN646AOtherFLMEDICARE
P1107159OtherFLOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100927000256 FL Part B Supplier - Clinic/Group Practice 0446376529 Receives reassigned benefits from 1 practitioner
Practice locations: Naples, FL

National Provider Directory

National Provider Directory

Locations

848 1st Ave N
Ste 230
Naples, FL 34102
Phone (239) 434-7779

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1396703369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 1ST AVE N",
            "address_2": "SUITE 230",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341026013",
            "telephone_number": "239-434-7779",
            "fax_number": "239-434-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 1ST AVE N",
            "address_2": "SUITE 230",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341026013",
            "telephone_number": "239-434-7779",
            "fax_number": "239-434-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE FORSZPANIAK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "FORSZPANIAK",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-434-7779",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME 49793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064785300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110050893",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DN646A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1107159",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.