Johanna M Forlivio, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

011693 Issued in NY

Practice address

159 Barnegat Rd
Poughkeepsie, NY 12601

Phone

(845) 452-9800

Fax

(845) 452-7691

NPI assigned

Mar 8, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, NC2 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 2

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• 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.

• Optum Medical Care, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment Care Compare group
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD
• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839
  Medicare reassignment
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Wakemed Specialists Group LLC

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group, LLC

  • Gastroenterology Physician
  • Raleigh, NC
  • NPI 1356906705
  NPD
• Mount Kisco Medical Group

  • Hematology (Internal Medicine) Physician
  • Fishkill, NY
  • NPI 1952356362
  NPD (past)

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

• Vassar Brothers Hospital

  • General Acute Care Hospital
  • Poughkeepsie, NY
  • NPI 1740233899
  Care Compare affiliation
• Vassar Brothers Medical Center

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1780052514

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1780715979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CLOCK TOWER CMNS",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094055",
            "telephone_number": "845-592-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BARNEGAT RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-452-9800",
            "fax_number": "845-452-7691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Reade Pl",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126013947",
            "country_code": "US",
            "telephone_number": "845-483-6559",
            "fax_number": "845-483-6108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORLIVIO",
        "first_name": "JOHANNA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02959171",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gena Fontus, MD
• Joshua John Foote, RN
• Karoline Ford
• Sonia Carolyn/Annette Forde, LPN
• Collrane Rachael Forestano, PA
• Afua Forson, M.D. M.H.S
• Brenda Forte-Miller
• Joseph Michael Forzano
• Michael Joseph Forzano, R.PH.
• Richard Jason Fost, PH.D.

• Medical Physician Assistant in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.