Gabriella Forman, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

78900 Issued in CT

Practice address

260 Long Ridge Rd
Stamford, CT 06902-1638

Phone

(475) 619-6035

NPI assigned

Mar 30, 2021

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 CT

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

Internal Medicine

Education

Drexel University College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018
• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gforman573059@direct.ynhh.org
• FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment Care Compare group NPD
• Mill Hill Medical Consultants Inc

  • Pain Medicine (Anesthesiology) Physician
  • Greenwich, CT
  • NPI 1144230954
  NPD
• Northeast Medical Group, PLLC

  • Internal Medicine Physician
  • Greenwich, CT
  • NPI 1942526207
  NPD (past)
• Stamford Health Medical Group Inc

  • General Practice Physician
  • Stamford, CT
  • NPI 1154633980
  NPD (past)

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

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation
• Greenwich Hospital

  • General Acute Care Hospital
  • Greenwich, CT
  • NPI 1609846088
  Care Compare affiliation

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1902484256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PERRYRIDGE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304697",
            "telephone_number": "203-863-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021638",
            "telephone_number": "475-619-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "GABRIELLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CT",
            "license": "78900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Forbes
• Farid Force, MD
• Devin Dallis Ford
• Suzanne Caroll Ford, OTR/L
• Erin Forler, LCSW
• Sharon M Fornaciari, MS, LPC
• Fortaleza Therapeutic Services, PLLC
• Rena Chase Fortier, MD
• Tabitha Fortt, MD
• Alec Fouche, PHARM. D

• Adult Medicine Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Adult Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.