Mark D Forman, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0573 Issued in AZ

Practice address

10605 N Hayden Rd
G 100
Scottsdale, AZ 85260-5686

Phone

(480) 423-8400

Fax

(480) 423-9773

NPI assigned

Sep 27, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Put Your Feet First, PC

  • Foot & Ankle Surgery Podiatrist
  • Scottsdale, AZ
  • NPI 1265551378
  Medicare reassignment NPD Authorized official

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

• Honorhealth

  dba HonorHealth Scottsdale Shea Medical Center

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1386608859
  Care Compare affiliation

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1861488512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 N HAYDEN RD",
            "address_2": "G 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605686",
            "telephone_number": "480-423-8400",
            "fax_number": "480-423-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 N HAYDEN RD",
            "address_2": "G 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605686",
            "telephone_number": "480-423-8400",
            "fax_number": "480-423-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "860355",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0195650",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenn R Foreman, DDS
• Forensic Assessment Practice Arizona, PLLC
• Forensic Counseling & Evaluations
• Kevin Patrick Forey II, MD-MBA
• Kelly Forkasdi
• Mary Ann Forrett, RNP
• Clay Garrett Forsberg, M.D.
• James R Forseth, M.D.
• Beani Jade Forst, M.D.
• Sarah Anne Forster, M.A.S., L.A.M.F.T.

• Podiatrist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.