Active NPI
James Steven Formoso, BC-HIS
- Specialist
- Broadview Heights, OH
National Provider Identifier
1538349345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2769
- Practice address
- 7985 Broadview Rd
Broadview Heights, OH 44147-1201 - Phone
- (440) 526-3700
- Fax
- (440) 526-3701
- NPI assigned
- Nov 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2769 | OH | Primary |
Addresses
Primary practice location
7985 Broadview Rd
Broadview Heights, OH 44147-1201
Mailing address
7985 Broadview Rd
Broadview Heights, OH 44147-1201
Phone (440) 526-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2769 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1538349345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7985 BROADVIEW RD",
"city": "BROADVIEW HEIGHTS",
"state": "OH",
"postal_code": "441471201",
"telephone_number": "440-526-3700",
"fax_number": "440-526-3701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7985 BROADVIEW RD",
"city": "BROADVIEW HEIGHTS",
"state": "OH",
"postal_code": "441471201",
"telephone_number": "440-526-3700",
"fax_number": "440-526-3701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMOSO",
"first_name": "JAMES",
"middle_name": "STEVEN",
"name_prefix": "Mr.",
"credential": "BC-HIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-08",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "2769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broadview Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.