Micah J Forman, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP9169904 Issued in FL

Practice address

4100 Metric Dr
Suite 200
Winter Park, FL 32792-6837

Phone

(407) 681-8720

Fax

(407) 681-8729

NPI assigned

Mar 8, 2011

Sex

Male

Sole proprietor

Yes

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 FL, NY, ME, MT, KS, HI, CO, TN8 enrollments

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 8

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pensacola Hospitalist Physicians LLCGroup PAC ID 5395159818, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Pensacola Hospitalist Physicians, LLC

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1487254140

  FL

  Medicare reassignment Care Compare group NPD
• Cogent Medical Care PC

  • Internal Medicine Physician
  • East Patchogue, NY
  • NPI 1912941238

  Nurse Practitioner, NY

  Medicare reassignment NPD
• Hospital Medicine Services of Maine LLC

  • Hospitalist Physician
  • Ellsworth, ME
  • NPI 1538638432

  ME

  Medicare reassignment NPD
• Maine Medical Services LLC

  • Hospitalist Physician
  • Ellsworth, ME
  • NPI 1053878371

  ME

  Medicare reassignment NPD
• Signify Health Medical Associates of Kansas LLC

  • Multi-Specialty Clinic/Center
  • Wichita, KS
  • NPI 1780261701

  KS

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  HI, ME, Nurse Practitioner

  Medicare reassignment NPD
• Integrity Virtual Health LLC

  • Adult Health Nurse Practitioner
  • Sterling, KS
  • NPI 1003672353
  NPD Authorized official
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  CO, MT, TN

  Medicare reassignment
• Central Florida Kidney Specialists Inc

  • Nephrology Physician
  • Orlando, FL
  • NPI 1346954138
  NPD
• Pensacola Hospitalist Physicians, LLC

  • Hospitalist Physician
  • Gulf Breeze, FL
  • NPI 1578164497
  NPD
• Renal Access of Central Florida LLC

  • Nephrology Physician
  • Altamonte Springs, FL
  • NPI 1790009165
  NPD (past)

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1689972192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S ORLANDO AVE",
            "address_2": "SUITE C",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894870",
            "telephone_number": "407-894-4693",
            "fax_number": "407-261-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 METRIC DR",
            "address_2": "SUITE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327926837",
            "telephone_number": "407-681-8720",
            "fax_number": "407-681-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MICAH",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9169904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela B Ford, MA
• Payton Riley-Brown Ford, MD
• Forefront Dermatology, S.C.
• Jennifer Forero
• Debra Ann Forman, CLINSCD., CCC/SLP
• Amanda Forsythe, COTA
• Carla E Fortune, AUD
• Forward Momentum Counseling
• Matthew Aaron Foss
• Four Lucky Kids, LLC

• All providers in Winter Park, FL
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.