Mary Rebecca Forgach, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-02139 Issued in NC

Practice address

1565 Purdue Dr
Suite 301
Fayetteville, NC 28303-5413

Phone

(910) 483-8586

Fax

(910) 483-9212

NPI assigned

Dec 31, 2009

Last updated

Dec 31, 2009By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

North Carolina Emergency Physicians PLLCGroup PAC ID 1355254947, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scotland Memorial Hospital Hospital, Laurinburg, NC, CCN 340008

Merit-based Incentive Payment System (MIPS)

Final score

99.49 of 100Reported as group

Quality

89.76

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Scotland Memorial Hospital Inc

  dba SURGICAL ASSOCIATES of SCOTLAND

  • Vascular Surgery Physician
  • Laurinburg, NC
  • NPI 1477791507
  Medicare reassignment Care Compare group NPD
• North Carolina Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Laurinburg, NC
  • NPI 1003861386
  Medicare reassignment Care Compare group
• Scotland Memorial Hospital Inc

  dba Sterling Surgical Services

  • Surgery Physician
  • Laurinburg, NC
  • NPI 1104918754
  NPD
• Angels Urgent Care, PC

  • Urgent Care Clinic/Center
  • Fayetteville, NC
  • NPI 1467768135
  NPD (past)
• Harris Family Practice PLLC

  • Family Medicine Physician
  • Laurinburg, NC
  • NPI 1992925978
  NPD (past)

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

• Scotland Memorial Hospital Inc

  • General Acute Care Hospital
  • Laurinburg, NC
  • NPI 1457345597
  Care Compare affiliation

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1821328576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 PURDUE DR",
            "address_2": "SUITE 301",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035413",
            "telephone_number": "910-483-8586",
            "fax_number": "910-483-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 PURDUE DR",
            "address_2": "SUITE 301",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035413",
            "telephone_number": "910-483-8586",
            "fax_number": "910-483-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORGACH",
        "first_name": "MARY",
        "middle_name": "REBECCA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colby Edward Fordham, PT
• Kandis Danielle Fordham, PA-C
• Forever Young Group Care
• Forever Young Group Care LLC
• Forever Young Group Care, LLC
• Forged by Fire Counseling Services, LLC (Mary Lynn Campbell)
• Shalita Shanta Forrest, RN
• Angela Ruff Forsyth, D.D.S.
• Suckia Forsythe, LCSWA
• Fort Liberty Elite Xpress N.E.M.T. LLC

• Medical Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.