Ferdinand Joseph Formoso, D.O.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

OS10067 Issued in FL

Practice address

11555 Central Pkwy
Suite 304
Jacksonville, FL 32224-2691

Phone

(904) 265-7755

Fax

(904) 265-7754

NPI assigned

May 9, 2007

Last updated

Apr 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Pain ManagementAlso: Osteopathic Manipulative Medicine, Physical Medicine and Rehabilitation

Education

New York College of Osteo Medicine of New York Institute of Technology, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Formoso Pain Specialists PAGroup PAC ID 3072936772, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Formoso Pain Specialists, PA

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville, FL
  • NPI 1487270351
  Medicare reassignment Care Compare group NPD Authorized official
• Formoso Pain Specialists, PA

  • Pain Clinic/Center
  • Jacksonville Beach, FL
  • NPI 1831850494
  NPD Authorized official
• Accmed Healthcare Systems Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville, FL
  • NPI 1215118062
  Medicare reassignment
• Formoso Pain Specialists, PA

  • Pain Clinic/Center
  • Jacksonville, FL
  • NPI 1548105372

  Pain Medicine

  NPD (past) Authorized official

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

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation Hospital Bartram Campus

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1801000161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242694",
            "telephone_number": "904-201-3111",
            "fax_number": "904-201-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY",
            "address_2": "SUITE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242691",
            "telephone_number": "904-265-7755",
            "fax_number": "904-265-7754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1361 13th Ave S Ste 170",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322503235",
            "country_code": "US",
            "telephone_number": "904-201-3111",
            "fax_number": "904-201-3095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMOSO",
        "first_name": "FERDINAND",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS10067",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "OS10067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaira Esthel Tesoro Forman, M.A.,BCBA
• Amanda Nicole Formella, RN
• Formoso Pain Specialists, PA
• Formoso Pain Specialists, PA
• Formoso Pain Specialists, PA
• Abigail Victoria Forness, M.S. CCC-SLP
• Masleidy Fornos Artiles, APRN
• Juliana Forrest-Lytle, PHD, LMHC
• Adam James Forrest, D.O.
• Amanda Forrest, LCSW

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.