Udo G Foreman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-02569 Issued in KS

Practice address

100 Michigan St NE
Grand Rapids, MI 49503-2560

Phone

(616) 391-1680

NPI assigned

Dec 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO, KS, NE3 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 3

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cambridge Memorial Hospital Inc 28 clinicians

Chase County Community Hospital 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri Valley Health System Hospital, Cambridge, NE, CCN 281348
• Chase County Community Hospital Hospital, Imperial, NE, CCN 281351
• Community Medical Center, Inc Hospital, Falls City, NE, CCN 281352

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/stanton-86bf40ec
• Direct secure messaging: udo.foreman.p1@direct.rwgcrhc.nextgenshare.com

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.

• Cambridge Memorial Hospital Inc

  • Critical Access Hospital
  • Cambridge, NE
  • NPI 1548333214

  NE

  Medicare reassignment Care Compare group NPD
• Cambridge Memorial Hospital Inc

  • Family Medicine Physician
  • Cambridge, NE
  • NPI 1740462654

  NE

  Medicare reassignment Care Compare group NPD
• Chase County Community Hospital

  • Critical Access Hospital
  • Imperial, NE
  • NPI 1609934843

  NE

  Medicare reassignment Care Compare group NPD
• Chase County Community Hospital

  • Family Medicine Physician
  • Imperial, NE
  • NPI 1033277751

  NE

  Medicare reassignment Care Compare group
• Complexcare Medical Group Kansas H LLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1073407227

  KS

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  KS, NE, Physician Assistant

  Medicare reassignment NPD
• East Phillips County Hospital District

  • Critical Access Hospital
  • Holyoke, CO
  • NPI 1891733879

  CO

  Medicare reassignment NPD
• Stanton County Hospital

  • Critical Access Hospital
  • Johnson, KS
  • NPI 1003964677

  KS

  Medicare reassignment NPD
• Community Medical Center, Inc.

  • Critical Access Hospital
  • Falls City, NE
  • NPI 1881643484

  NE

  Medicare reassignment
• Kit Carson County Health Services District

  • Rural Health Clinic/Center
  • Burlington, CO
  • NPI 1932211596

  CO

  Medicare reassignment
• Chase County Community Hospital

  • Rural Health Clinic/Center
  • Wauneta, NE
  • NPI 1558429472
  Care Compare group NPD (past)
• Cambridge Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Arapahoe, NE
  • NPI 1053408583
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cambridge Memorial Hospital Inc

  • Critical Access Hospital
  • Cambridge, NE
  • NPI 1548333214

  Hospital

  Care Compare affiliation
• Chase County Community Hospital

  • Critical Access Hospital
  • Imperial, NE
  • NPI 1609934843

  Hospital

  Care Compare affiliation
• Community Medical Center, Inc.

  • Critical Access Hospital
  • Falls City, NE
  • NPI 1881643484

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1750685335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 MOMENTUM PL",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895325",
            "telephone_number": "616-975-1845",
            "fax_number": "616-285-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "UDO",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-22",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006199",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3145",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2745",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "5410563",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Forde
• Gareth Karl Forde, M.D.
• Forefront Dermatology, S.C.
• Forefront Dermatology, S.C.
• Carolyn Foreman
• Evan Foresman
• Forest Hills Dental, P.C.
• Forest Hills Pediatric Associates, PC
• Forest Hills Podiatry
• Forest Hills Podiatry PC

• All providers in Grand Rapids, MI
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.