Individual provider Active NPI

Roan Emanuel Forgie

  • Psychiatric/Mental Health Nurse Practitioner
  • Winter Garden, FL
National Provider Identifier
1578744314
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F403033 Issued in NY
Practice address
3065 Daniels Rd # 1077
Winter Garden, FL 34787-7002
Phone
(646) 591-4970
NPI assigned
Nov 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 273030 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F403033 NY Primary

Addresses

Primary practice location

3065 Daniels Rd # 1077
Winter Garden, FL 34787-7002

Mailing address

669 E 237TH St
Bronx, NY 10466-1409
Phone (646) 591-4970

Other identifiers 1

IdentifierTypeStateIssuer
02907775MedicaidNY

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
I20201217002909 NY Practitioner - Nurse Practitioner 8325450232 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Horizon Counseling Center IncGroup PAC ID 4880681295, 87 clinicians
Seth Benkel MD PLLCGroup PAC ID 8325331317, 14 clinicians

Practice addresses (Care Compare)

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034
Phone (718) 845-2620

50 W Hawthorne Ave
FL 2
Valley Stream, NY 11580-6220
Phone (718) 471-0200

70 Father Capodanno Blvd
Staten Island, NY 10305-4803
Phone (718) 273-8900

712 Beach 20TH St
Far Rockaway, NY 11691-3502
Phone (718) 471-0200

799 E Gun Hill Rd
Bronx, NY 10467-6107
Phone (718) 881-9100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273030NYMDLicensed Practical Nurse
F403033NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Downtown Bronx Medical Associates PC CurrentSince Jul 14, 2020 Accepting new patients
Catholic Charities Neighborhood Services, Inc. CurrentSince May 7, 2021 Accepting new patients
Seth Benkel, MD, PLLC CurrentSince Apr 17, 2024 Accepting new patients
New Horizon Counseling Center Inc CurrentSince Jan 22, 2024 Accepting new patients
Forgie Nurse Practitioner in Psychiatry Health Services PC Psychiatric/Mental Health CurrentSince Mar 27, 2022 Accepting new patients
Catholic Charities Neigborhood Services Past Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

1623 Flatbush Ave
Brooklyn, NY 11210
Phone (718) 377-5755

191 Joralemon St
Fl 11
Brooklyn, NY 11201

445 Oak St
Copiague, NY 11726
Phone (631) 257-5173

712 Beach 20th St
Far Rockaway, NY 11691
Phone (718) 327-0466

6729 Myrtle Ave
Glendale, NY 11385
Phone (718) 456-7001

16110 Jamaica Ave
Fl 2
Jamaica, NY 11432
Phone (718) 674-1000

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

50 W Hawthorne Ave
Fl 2
Valley Stream, NY 11580
Phone (718) 471-0200

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1578744314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 E 237TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104661409",
            "telephone_number": "646-591-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 DANIELS RD # 1077",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347877002",
            "telephone_number": "646-591-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORGIE",
        "first_name": "ROAN",
        "middle_name": "EMANUEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "273030",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02907775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.