Individual provider Active NPI

Jonathan Robert Forquer, D.O.

  • Cardiovascular Disease Physician
  • Lancaster, OH
National Provider Identifier
1396977385
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34010160 Issued in OH
Practice address
2405 N Columbus St
Suite 100
Lancaster, OH 43130-8185
Phone
(740) 689-4480
Fax
(740) 277-7692
NPI assigned
Aug 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 34010160 OH Primary
Internal Medicine Physician 207R00000X 34-010160 OH

Addresses

Primary practice location

2405 N Columbus St
Suite 100
Lancaster, OH 43130-8185

Mailing address

1153 E Main St
PO Box 2563
Lancaster, OH 43130-4056
Phone (740) 687-8990

Other identifiers 1

IdentifierTypeStateIssuer
0065345MedicaidOH

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110829000279 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1759551856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfield Healthcare Professionals IncGroup PAC ID 4789596362, 144 clinicians

Practice addresses (Care Compare)

131 N Ewing St
Lancaster, OH 43130-3383

401 N Ewing St
Lancaster, OH 43130-3372
Phone (740) 689-4404

5115 Amanda Northern Rd
Amanda, OH 43102-9332
Phone (740) 969-4828

6898 Hunter Dr NE
New Lexington, OH 43764-1053
Phone (740) 687-4480

819 State Route 664 N
Side a
Logan, OH 43138-8540
Phone (740) 689-4430

Hospital & facility affiliations

  • Fairfield Medical Center Hospital, Lancaster, OH, CCN 360072
  • Ohiohealth O'Bleness Hospital Hospital, Athens, OH, CCN 360014
  • Hocking Valley Community Hospital Hospital, Logan, OH, CCN 361330
  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039

Merit-based Incentive Payment System (MIPS)

Final score
76.95 of 100Reported as group
Quality
43.39
Promoting interoperability
100
Improvement activities
40
Cost
76.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-010160OHMDInternal Medicine Physician
34010160OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Healthcare Professionals, Inc. CurrentSince Aug 8, 2016 Accepting new patients
Fairfield Healthcare Professionals Inc CurrentSince Aug 8, 2016 Accepting new patients
Fairfield Healthcare Professionals, Inc. Past Accepting new patients
Fairfield Medical Center Past Accepting new patients

Locations

131 N Ewing St
Ste C
Lancaster, OH 43130
Phone (740) 689-6600

2405 N Columbus St
Ste 100
Lancaster, OH 43130
Phone (614) 908-1339

1153 E Main St
Lancaster, OH 43130
Phone (740) 687-8990

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

2405 N Columbus St
Ste 200
Lancaster, OH 43130
Phone (740) 689-3627

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1396977385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 E MAIN ST",
            "address_2": "PO BOX 2563",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304056",
            "telephone_number": "740-687-8990",
            "fax_number": "740-687-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST",
            "address_2": "SUITE 100",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308185",
            "telephone_number": "740-689-4480",
            "fax_number": "740-277-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORQUER",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34010160",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34-010160",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065345",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.