Individual provider Active NPI

Edmund John Forte, M.D.

  • Ophthalmology Physician
  • Salisbury, MD
National Provider Identifier
1609938224
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0036073 Issued in MD
Practice address
101 Milford St
Salisbury, MD 21804-6952
Phone
(410) 749-9290
Fax
(410) 543-9087
NPI assigned
Dec 14, 2006
Last updated
Apr 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0036073 MD Primary

Addresses

Primary practice location

101 Milford St
Salisbury, MD 21804-6952

Mailing address

101 Milford St
Salisbury, MD 21804-6952
Phone (410) 749-9290

Other identifiers 7

IdentifierTypeStateIssuer
276801100MedicaidMD
352275OtherMDCAREFIRST BCBS
0000102201MedicaidDE
006356231MedicaidVA
T6990003OtherMDCAREFIRST BLUE CHOICE
20885OtherMAMSI
4410369OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20110610000687 DE Practitioner - Ophthalmology 1052495058 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Eye Center, P.a Current Accepting new patients
Sussex Eye Center PA PastSince Jul 1, 2006 Accepting new patients

Locations

101 Milford St
Salisbury, MD 21804
Phone (410) 749-9290

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1609938224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MILFORD ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046952",
            "telephone_number": "410-749-9290",
            "fax_number": "410-543-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MILFORD ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046952",
            "telephone_number": "410-749-9290",
            "fax_number": "410-543-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTE",
        "first_name": "EDMUND",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0036073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276801100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "352275",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000102201",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006356231",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CHOICE",
            "identifier": "T6990003",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "20885",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4410369",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.