Timothy Saint Clair Forshay, PA-C
Individual provider Active NPI Physician Assistant · Salem, UT
NPI 1902184690 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1902184690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 10248445-1206 (UT)
- Practice address
- 555 W Sr 164
Salem, UT 84653 - Phone
- (801) 465-4896
- Fax
- (801) 465-3267
- NPI assigned
- Jul 28, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Utah Carenow Urgent Care LLC
Practice addresses (Care Compare)
117 N State St
Orem, UT 84057-5509
Phone (801) 607-3130
441 S Redwood Rd
Salt Lake City, UT 84104-3539
Phone (801) 973-2588
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170607001275 | UT | Practitioner - Physician Assistant | 4981849163 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Utah Valley Radiology Associates Inc | Past |
Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Billings Clinic Express Care, LLC | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0004505 | CO | |
| Physician Assistant | 363A00000X | 10248445-1206 | UT | Yes |
Addresses
Primary practice location
555 W Sr 164
Salem, UT 84653
Mailing address
1055 N 500 W Attn: Credentialing
Provo, UT 84604
Phone (801) 354-8225
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC |
Other providers in Salem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.