Individual provider Active NPI

Adam M Forman, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1992094296
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301099568 Issued in MI
Practice address
22301 Foster Winter Dr Ste 200
Southfield, MI 48075-3707
Phone
(248) 552-0620
NPI assigned
Apr 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301099568 MI Primary

Addresses

Primary practice location

22301 Foster Winter Dr Ste 200
Southfield, MI 48075-3707

Mailing address

22301 Foster Winter Dr
Southfield, MI 48075-3707
Phone (248) 552-0620

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180413001316 MI Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5193015725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

22301 Foster Winter Dr 3Rd Floor
Sjhmc V K Malviya MD
Southfield, MI 48075-3707
Phone (248) 849-8140

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jul 1, 2018 Accepting new patients
Henry Ford Health St. John Hospital Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
St. John Hospital Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

26850 Providence Pkwy
Ste 375
Novi, MI 48374
Phone (248) 662-4200

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

47601 Grand River Ave
Ste 2
Novi, MI 48374
Phone (248) 344-2000

22301 Foster Winter Dr
Fl 3
Southfield, MI 48075
Phone (248) 849-8140

22301 Foster Winter Dr
Fl 3RD
Southfield, MI 48075
Phone (248) 424-3321

22301 Foster Winter Dr
Southfield, MI 48075
Phone (248) 849-3541

22301 Foster Winter Dr
Ste 200
Southfield, MI 48075
Phone (248) 424-3186

22301 Foster Winter Dr
Fl 2
Southfield, MI 48075
Phone (248) 562-0620

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

Interoperability endpoints

  • Direct secure messaging: aforman1127024@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1992094296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-552-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-552-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "ADAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301099568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.