Individual provider Active NPI

Penina R Forta, PA-C

  • Physician Assistant
  • Royal Oak, MI
National Provider Identifier
1932986668
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011914 Issued in MI
Practice address
31157 Woodward Ave
Royal Oak, MI 48073-0996
Phone
(248) 336-0123
NPI assigned
Sep 14, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011914 MI Primary

Addresses

Primary practice location

31157 Woodward Ave
Royal Oak, MI 48073-0996

Mailing address

14520 Sherwood St
Oak Park, MI 48237-1386
Phone (248) 219-7268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20231031001202 MI Practitioner - Physician Assistant 1456707231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

31157 Woodward Ave
Royal Oak, MI 48073-0996
Phone (248) 336-0123

32255 Northwestern Hwy
Farmington Hills, MI 48334-1575

32255 Northwestern Hwy 135
Mi Healthcare Prof. PC
Farmington Hills, MI 48334-1575
Phone (947) 228-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Oct 1, 2023 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Oct 1, 2023 Accepting new patients
Michigan Healthcare Professionals PC Past Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

32255 Northwestern Hwy
Ste 105
Farmington Hills, MI 48334
Phone (248) 406-1090

31157 Woodward Ave
Royal Oak, MI 48073
Phone (248) 288-2250

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: penina.forta.1@18740.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1932986668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14520 SHERWOOD ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371386",
            "telephone_number": "248-219-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31157 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730996",
            "telephone_number": "248-336-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTA",
        "first_name": "PENINA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.