Amanda Ann Forman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01532100 Issued in NJ

Practice address

700 S White Horse Pike
Somerdale, NJ 08083-1253

Phone

(609) 504-6930

NPI assigned

Dec 8, 2013

Sex

Female

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 NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fast Track Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Somerdale, NJ
  • NPI 1992009203

  NJ

  Medicare reassignment NPD
• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  NJ, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1386460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1679904205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S WHITE HORSE PIKE",
            "city": "SOMERDALE",
            "state": "NJ",
            "postal_code": "080831253",
            "telephone_number": "856-504-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S WHITE HORSE PIKE",
            "city": "SOMERDALE",
            "state": "NJ",
            "postal_code": "080831253",
            "telephone_number": "609-504-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "AMANDA",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-08",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01532100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Faust
• Frances Marie Feigl, M.D.
• Laura Fitzgerald, MS RD LDN
• Amy Fleischman, P.T.
• Jason Forbes
• Friends of Cyrus II
• Samantha Helen Galson, MA, LPC, LCPC,LCMHC
• Kassandra Nahomy Garcia-Giron
• Theresa M Gelzinis-Enoch, RN
• Jane Susan Ginsburg, LPT

• All providers in Somerdale, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.