REBECCA BELLA FORMAN
NPI 1124683651
Student in an Organized Health Care Education/Training Program in New Haven, CT
About Rebecca Bella Forman NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REBECCA BELLA FORMAN (NPI 1124683651) is an individual student in an organized health care education/training program in New Haven, Connecticut and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Rebecca Bella Forman is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Rebecca Forman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19146
- Reassigned Medicare billing, Pennsylvania enrollment
- Also billed through NPI 1679677975 (Pennsylvania)
- 752 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Hospital Of Univ Of Pennsylvania
Acute Care Hospitals · Philadelphia, PAPenn Presbyterian Medical Center
Acute Care Hospitals · Philadelphia, PAPennsylvania Hospital
Acute Care Hospitals · Philadelphia, PAOther 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 HAVEN, CT 06510
NEW HAVEN, CT 06510
NEW HAVEN, CT 06510
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 Rebecca Forman's NPI number?
The NPI number for Rebecca Forman is 1124683651. It was assigned to this individual provider in the NPPES registry on May 9, 2019. The provider is also known as Rebecca Bella Gross.
Where is Rebecca Forman located?
Rebecca Forman practices at 20 York St, New Haven, CT 06510. The listed phone number is (203) 688-4242.
What is Rebecca Forman's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Rebecca Forman enrolled in Medicare?
Yes. Rebecca Forman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Rebecca Forman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Rebecca Forman reassigns Medicare benefits to University Of Penn - Medical Group (Philadelphia, PA). The 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 Rebecca Forman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Rebecca Forman accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Rebecca Forman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Rebecca Forman affiliated with any hospitals?
According to CMS data, Rebecca Forman is affiliated with Hospital Of Univ Of Pennsylvania, Penn Presbyterian Medical Center and Pennsylvania Hospital.
When was this NPI record last updated?
The NPPES record for Rebecca Forman was last updated on May 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Rebecca Bella Forman · NPI 1124683651
Student in an Organized Health Care Education/Training Program provider in New Haven, Connecticut. Individual provider, active in the CMS NPPES registry since May 9, 2019.
## Identity
- **NPI:** 1124683651 (Entity type: Individual)
- **Enumerated:** May 9, 2019
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 20 YORK ST, New Haven, CT 06510-3220
- **Phone:** (203) 688-4242
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Of Penn - Medical Group (NPI 1114481504, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** May 9, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1124683651) · Data from the CMS NPPES public registry.