Individual provider Active NPI

Jodi M Forwand, MD

  • Emergency Medicine Physician
  • Plattsburgh, NY
National Provider Identifier
1477604684
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21863001 Issued in NY
Practice address
75 Beekman St
Plattsburgh, NY 12901-1438
Phone
(518) 562-7900
Fax
(518) 562-7933
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21863001 NY Primary

Addresses

Primary practice location

75 Beekman St
Plattsburgh, NY 12901-1438

Mailing address

PO Box 2868
Plattsburgh, NY 12901-0259
Phone (518) 562-7900

Other identifiers 1

IdentifierTypeStateIssuer
02242657MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20101208001061 VT Practitioner - Emergency Medicine 8022205699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Vermont College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Center IncGroup PAC ID 5496714313, shared by 4 NPIs, 105 clinicians

Practice addresses (Care Compare)

133 Fairfield St
Suite 102
Saint Albans, VT 05478-1726
Phone (802) 524-5911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21863001NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center Inc CurrentSince Apr 9, 2018 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center, Inc. CurrentSince Nov 1, 2010 Accepting new patients
Northwestern Medical Center, Inc CurrentSince Nov 1, 2010 Accepting new patients

Locations

927 Ethan Allen Hwy
Unit 2
Milton, VT 05468
Phone (802) 524-8911

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

133 Fairfield St
Ste 102
Saint Albans, VT 05478
Phone (802) 524-5911

260 Crest Rd
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1223

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

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 1

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477604684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2868",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129010259",
            "telephone_number": "518-562-7900",
            "fax_number": "518-562-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BEEKMAN ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011438",
            "telephone_number": "518-562-7900",
            "fax_number": "518-562-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORWAND",
        "first_name": "JODI",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "21863001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02242657",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.