MS. JESSICA S. FORMAN PA-C
NPI 1114067212
Physician Assistant - Medical in New York, NY
About Ms. Jessica S. Forman Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. JESSICA S. FORMAN PA-C (NPI 1114067212) is an individual medical provider in New York, New York, licensed in New York (006986) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ms. Jessica S. Forman Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10032
NEW YORK, NY 10032
NEW YORK, NY 10032
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 Jessica Forman's NPI number?
The NPI number for Jessica Forman is 1114067212. It was assigned to this individual provider in the NPPES registry on February 7, 2007.
Where is Jessica Forman located?
Jessica Forman practices at 177 Fort Washington Ave 5th Floor - 5 Garden North, New York, NY 10032. The listed phone number is (212) 342-3622.
What is Jessica Forman's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Jessica Forman enrolled in Medicare?
Yes. Jessica Forman is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jessica Forman was last updated on December 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Ms. Jessica S. Forman, PA-C · NPI 1114067212
Medical physician in New York, New York. Individual provider, active in the CMS NPPES registry since February 7, 2007.
## Identity
- **NPI:** 1114067212 (Entity type: Individual)
- **Enumerated:** February 7, 2007
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 006986 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 177 FORT WASHINGTON AVE, 5TH FLOOR - 5 GARDEN NORTH, New York, NY 10032-3733
- **Phone:** (212) 342-3622
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** December 8, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1114067212) · Data from the CMS NPPES public registry.