Peter Forman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

025004 Issued in NY

Practice address

86 Saint Felix St
Brooklyn, NY 11217-3032

Phone

(347) 529-4936

NPI assigned

Aug 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Be Well Primary Health Care Center LLCGroup PAC ID 2062305030, 44 clinicians

North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

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

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.

• Be Well Primary Health Care Center, LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1083623409
  Medicare reassignment Care Compare group
• North Shore Hematology Oncology Associates PC

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1396794574
  Medicare reassignment Care Compare group
• Century Medical & Dental Center Inc

  • Health Service Clinic/Center
  • Brooklyn, NY
  • NPI 1144399098
  Medicare reassignment
• Suny Downstate Medical Center

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1699704155
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1669084547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 HENRY ST APT 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112313018",
            "telephone_number": "571-344-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 SAINT FELIX ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112173032",
            "telephone_number": "347-529-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "PETER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Forman
• Liza Janine Zeif Forman
• Lynda Joyce Forman
• Melanie Forman, LMSW
• Mozelle Forman
• Stephen Formanowicz
• Formula-Depot Inc.
• Robert Francis Foronjy, M.D.
• Neisha S Forrest
• Nicole Geisha Forrest

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.