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MR. JAY MILES FORMAN PA-C
NPI 1073826517
Physician Assistant - Surgical in Gloucester, VA

Active since July 26, 2010PECOS Enrolled
94.07/100
CMS Quality Rating
7544 HOSPITAL DR, SUITE 202A, GLOUCESTER, VA 23061(804) 693-0529(804) 693-1670 Get Directions Write a Review

NPPES record last updated: November 26, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Jay Miles Forman Pa-c NPPES

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

MR. JAY MILES FORMAN PA-C (NPI 1073826517) is an individual surgical provider in Gloucester, Virginia, licensed in Virginia (0110003739) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073826517
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. JAY MILES FORMANCredential: PA-C
Location Address7544 HOSPITAL DR, SUITE 202AGloucester, VA 23061-4178
Mailing Address856 J Clyde Morris Blvd, Suite ANewport News, VA 23601-1318
Phone(804) 693-0529
Fax(804) 693-1670
Sole ProprietorNo
Enumeration DateJuly 26, 2010
Last NPPES UpdateNovember 26, 2013
✔ NPI 1073826517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in VA · 0110003739
7544 HOSPITAL DR, Gloucester, VA 23061
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jay Miles Forman Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
199 services185 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
154 services149 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
52 services51 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
25 services25 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
12 services11 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.07/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality90.65
Promoting Interoperability95.83
Improvement Activities40

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL JOHN ABADIER DO
Internal Medicine (Pulmonary Disease)
7544 HOSPITAL DR
GLOUCESTER, VA 23061
Gloucester County (804) 695-8501
BARBARO JESUS PEREZ MD
Orthopaedic Surgery
7544 HOSPITAL DR, STE 202A
GLOUCESTER, VA 23061
Gloucester County (804) 693-0529
STEVEN J HOSPODAR MD
Orthopaedic Surgery
7544 HOSPITAL DR, SUITE 202A
GLOUCESTER, VA 23061
Gloucester County (804) 693-0529

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 Jay Forman's NPI number?

The NPI number for Jay Forman is 1073826517. It was assigned to this individual provider in the NPPES registry on July 26, 2010.

Where is Jay Forman located?

Jay Forman practices at 7544 Hospital Dr Suite 202A, Gloucester, VA 23061. The listed phone number is (804) 693-0529.

What is Jay Forman's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jay Forman enrolled in Medicare?

Yes. Jay Forman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jay Forman was last updated on November 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.