Individual provider Active NPI

Rachel J Forberg, F.N.P.

  • Family Nurse Practitioner
  • North Chili, NY
National Provider Identifier
1497791271
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F332225-1 Issued in NY
Practice address
4201 Buffalo Rd Ste 1
North Chili, NY 14514-1256
Phone
(585) 594-5995
Fax
(585) 594-5425
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 433456-1 NY
Family Nurse Practitioner 363LF0000X F332225-1 NY Primary

Addresses

Primary practice location

4201 Buffalo Rd Ste 1
North Chili, NY 14514-1256

Mailing address

PO Box 505
North Chili, NY 14514-0505
Phone (585) 594-5995

Other identifiers 4

IdentifierTypeStateIssuer
005605372OtherNYHEALTHNOW BSWNY BRCKPRT
019332225OtherNYEXCELLUS
02346849MedicaidNY
109371BFOtherNYPREFERRED CARE

Other names 1

  • Rachel J Bunt Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20051003000316 NY Practitioner - Nurse Practitioner 0446285019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Churchville-Chili Family Medicine LLCGroup PAC ID 5294957874, 12 clinicians

Practice addresses (Care Compare)

4201 Buffalo Rd
Suite 1
North Chili, NY 14514-1256
Phone (585) 594-5995

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
433456-1NYMDRegistered Nurse
F332225-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rforberg@ccfm.medentdirect.com

Organizations & group practices 2

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 2

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1497791271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145140505",
            "telephone_number": "585-594-5995",
            "fax_number": "585-594-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 BUFFALO RD STE 1",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145141256",
            "telephone_number": "585-594-5995",
            "fax_number": "585-594-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBERG",
        "first_name": "RACHEL",
        "middle_name": "J",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "433456-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332225-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNOW BSWNY BRCKPRT",
            "identifier": "005605372",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "019332225",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02346849",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "109371BF",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "BUNT",
            "middle_name": "J",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Chili, NY

Sources for this page

Verify at the official NPI Registry.