Individual provider Active NPI

Thomas Joseph Forlenza, MD

  • Hematology & Oncology Physician
  • Staten Island, NY
National Provider Identifier
1619978442
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
136150 Issued in NY
Practice address
1366 Victory Blvd
Staten Island, NY 10301-3907
Phone
(718) 816-4949
Fax
(718) 273-5504
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 136150 NY Primary

Addresses

Primary practice location

1366 Victory Blvd
Staten Island, NY 10301-3907

Mailing address

1366 Victory Blvd
Staten Island, NY 10301-3907
Phone (718) 816-4949

Other identifiers 1

IdentifierTypeStateIssuer
00778405MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100220000374 NY Practitioner - HematologyPractitioner - Hematology/OncologyPractitioner - Medical OncologyPractitioner - Hospice/Palliative Care 5890839419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HematologyAlso: Hospice/Palliative Care, Medical Oncology
Education
Boston University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

1000 S Ave
Staten Island, NY 10314-3409
Phone (718) 370-2100

355 Bard Ave
Staten Island, NY 10310-1664

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Mar 1, 2013 Accepting new patients
Amboy Medical Practice PC CurrentSince Mar 1, 2013 Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

1000 South Ave
Staten Island, NY 10314
Phone (718) 226-6780

1366 Victory Blvd
Staten Island, NY 10301
Phone (718) 273-3400

Networks

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

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1619978442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013907",
            "telephone_number": "718-816-4949",
            "fax_number": "718-273-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013907",
            "telephone_number": "718-816-4949",
            "fax_number": "718-273-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORLENZA",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "136150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00778405",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.