Dana Christine Forman, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704267480 Issued in MI

Practice address

3310 W Big Beaver Rd
#137
Troy, MI 48084-2809

Phone

(248) 792-5200

NPI assigned

Dec 21, 2016

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 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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bicycle Health Medical Group PAGroup PAC ID 0244643872, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dana.forman.1@18731.direct.athenahealth.com

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.

• Bicycle Health Medical Group PA

  • Addiction Medicine (Family Medicine) Physician
  • Seattle, WA
  • NPI 1194342162

  MI

  Medicare reassignment Care Compare group NPD
• Bicycle Health Provider Group Inc.

  • Addiction Medicine (Family Medicine) Physician
  • San Jose, CA
  • NPI 1356817886
  NPD (past)

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1942745252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31207 PICKWICK LN",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255244",
            "telephone_number": "517-303-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 W BIG BEAVER RD",
            "address_2": "#137",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842809",
            "telephone_number": "248-792-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "DANA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704267480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalimah Forbes-Trinidad, MA, LLC
• Jennifer R. Forche, PH.D.
• Carolyn Ford
• Jessica Foreman
• Tricia Michelle Forgash, CTRS
• David H Forst, M.D.
• Kai A Forte, NP
• Hannah Elizabeth Fortune
• Caitlyn Foster, PA-C
• Deanna Madora Foster

• Adult Health Nurse Practitioner in Troy, MI
• Providers in Troy, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.