Active NPI
Suzanne Dee Forman, MD
- Psychiatry Physician
- Gaithersburg, MD
National Provider Identifier
1720195159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0052427
- Practice address
- 9037 Shady Grove Court
Gaithersburg, MD 20877 - Phone
- (301) 938-0663
- Fax
- (240) 654-3313
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D0052427 | MD | Primary |
Addresses
Primary practice location
9037 Shady Grove Court
Gaithersburg, MD 20877
Mailing address
9037 Shady Grove Court
Gaithersburg, MD 20877
Phone (301) 938-0663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 450712600 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hanei Health Solutions, LLC | Current | Accepting new patients |
Locations
9037 Shady Grove Ct
Gaithersburg, MD 20877
Phone (240) 388-2031
Organizations & group practices 1
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Catonsville, MD
- NPI 1902435365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1720195159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9037 SHADY GROVE COURT",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "20877",
"telephone_number": "301-938-0663",
"fax_number": "240-654-3313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9037 SHADY GROVE COURT",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "20877",
"telephone_number": "301-938-0663",
"fax_number": "240-654-3313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMAN",
"first_name": "SUZANNE",
"middle_name": "DEE",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0052427",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "450712600",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.