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FORM HEALTH ASSOCIATES, P.C.
NPI 1043835044
Internal Medicine - Endocrinology, Diabetes & Metabolism in Bakersfield, CA

Active since June 15, 2020
4900 CALIFORNIA AVENUE, TOWER B, 2ND FLOOR, BAKERSFIELD, CA 93309(617) 505-1520(617) 928-8401 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 18, 2026, Feb 24, 2022, Jun 14, 2021 and 2 more (5 updates tracked since 2020).

About Form Health Associates, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORM HEALTH ASSOCIATES, P.C. (NPI 1043835044) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Bakersfield, California and active in the NPI registry since June 2020. The organization lists Nam Ho Kim, President, as its authorized official.

NPPES Registry Identity

NPI1043835044
Entity TypeOrganization
Primary Taxonomy207RE0101X
Legal Business NameFORM HEALTH ASSOCIATES, P.C.
Location Address4900 CALIFORNIA AVENUE, TOWER B, 2ND FLOORBakersfield, CA 93309-7024
Mailing Address109 State Street, 5th FlBoston, MA 02109-2906 · (617) 505-1520 · Fax (617) 928-8401
Phone(617) 505-1520
Fax(617) 928-8401
Organization SubpartNo
Authorized OfficialNam Ho KimPresident · (617) 505-1520
Enumeration DateJune 15, 2020
Last NPPES UpdateMarch 18, 20265 updates tracked since enumeration
NPPES CertifiedMarch 18, 2026
✔ NPI 1043835044 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedFamily MedicineTaxonomy 207Q00000X
4900 CALIFORNIA AVENUE, Bakersfield, CA 93309
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Form Health Associates, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

12

Medicare enrollment records show 12 clinicians reassign Medicare billing to Form Health Associates, P.C., which bills Medicare for the services they deliver. Of these, 7 practice at this address. They are listed nearest first.

Clinicians by Medicare Specialty 3

Internal Medicine5
Nurse Practitioner4
Family Practice3

Clinicians, nearest first (12)

Shelley Anderson, NP
Nurse Practitioner
NPI 1457812299
4900 CALIFORNIA AVENUE TOWER B, 2ND FLOOR
Bakersfield, CA 93309
(617) 505-1520
✔ PECOS✔ Accepts MedicareSame address
Lisa Gause, FNP-BC
Nurse Practitioner
NPI 1932302973
4900 CALIFORNIA AVE FL 2
Bakersfield, CA 93309
(617) 505-1520
✔ PECOSSame address
Lauren Lemieux
Internal Medicine
NPI 1912393463
4900 CALIFORNIA AVENUE TOWER B, 2ND FLOOR
Bakersfield, CA 93309
(617) 505-1520
✔ PECOSSame address
Melanie Madriaga, DO
Family Practice
NPI 1144717836
4900 CALIFORNIA AVE FL 2 TOWER B, 2ND FLOOR
Bakersfield, CA 93309
(617) 505-1520
✔ PECOSSame address
Kathleen Mayer, MD
Internal Medicine
NPI 1457488439
4900 CALIFORNIA AVE FL 2
Bakersfield, CA 93309
(617) 505-1520
✔ PECOSSame address
Angelica Neison, MD
Family Practice
NPI 1770787137
4900 CALIFORNIA AVENUE TOWER B, 2ND FLOOR
Bakersfield, CA 93309
(617) 505-1520
✔ PECOSSame address
Arline Yen, M.D.
Internal Medicine
NPI 1841540564
4900 CALIFORNIA AVENUE TOWER B, 2ND FLOOR
Bakersfield, CA 93309
(617) 505-1520
✔ PECOSSame address
Clara Lyashevsky
Family Practice
NPI 1962922690
2428 SANTA MONICA BLVD STE 200
Santa Monica, CA 90404
(310) 998-5868
✔ PECOS98 mi
Courtney Covert, FNP-C
Nurse Practitioner
NPI 1013464148
100 FILLMORE ST FL 5
Denver, CO 80206
(617) 505-1520
✔ PECOS✔ Accepts Medicare829 mi
Tejaswi Kompala, MD
Internal Medicine
NPI 1235558255
100 FILLMORE ST FL 5
Denver, CO 80206
(617) 505-1520
✔ PECOS829 mi
Julia Pierce, MD
Internal Medicine
NPI 1669468245
100 FILLMORE ST FL 5
Denver, CO 80206
(617) 505-1520
✔ PECOS✔ Accepts Medicare829 mi
Christine Stesney, FNP
Nurse Practitioner
NPI 1548686975
1688 MERIDIAN AVE STE 700
Miami Beach, FL 33139
(617) 505-1520
✔ PECOS2,395 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Form Health Associates, P.C.'s NPI number?

The NPI number for Form Health Associates, P.C. is 1043835044. It was assigned to this organization in the NPPES registry on June 15, 2020.

Where is Form Health Associates, P.C. located?

Form Health Associates, P.C. is located at 4900 California Avenue Tower B, 2nd Floor, Bakersfield, CA 93309. The listed phone number is (617) 505-1520.

What is Form Health Associates, P.C.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Form Health Associates, P.C. enrolled in Medicare?

Yes. Form Health Associates, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Form Health Associates, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 3 Medicare specialties reassign their Medicare billing to Form Health Associates, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (5), Nurse Practitioner (4) and Family Practice (3). Of these, 7 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Form Health Associates, P.C. was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.