MEDI SCENE
NPI 1144402983
General Practice in Latham, NY

Q: What is Everett Forman PC's NPI number?

The NPI number for Everett Forman PC is 1144402983. It was assigned to this organization in the NPPES registry on December 4, 2007. The provider is doing business as Medi Scene.

Q: What is Everett Forman PC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Everett Forman PC was last updated on December 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since December 04, 2007CLIA 33D0709329 · Microscopy

585 TROY SCHENECTADY RD, LATHAM, NY 12110(518) 785-6004(518) 785-1702 Get Directions Write a Review

NPPES record last updated: December 19, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Medi Scene NPPES

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

MEDI SCENE (NPI 1144402983) is a healthcare organization registered as a general practice in Latham, New York and active in the NPI registry since December 2007. The organization holds a CLIA Microscopy certificate valid through July 22, 2027 and lists Everett Roy Forman, President, as its authorized official.

NPPES Registry Identity

NPI1144402983

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameEVERETT FORMAN PC

Location Address585 TROY SCHENECTADY RDLatham, NY 12110-2811

Mailing Address47 Sweet RdBallston Lake, NY 12019-1805 · (518) 899-6657 · Fax (518) 899-0023

Phone(518) 785-6004

Fax(518) 785-1702

Organization SubpartNo

Authorized OfficialEverett Roy FormanPresident · (518) 899-6657

Enumeration DateDecember 4, 2007

Last NPPES UpdateDecember 19, 2007

✔ NPI 1144402983 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

585 TROY SCHENECTADY RD, Latham, NY 12110

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Other Names 1

Doing Business AsMedi Scene

Other Identifiers 6

Medicare UPIND02266NY

Other10000672NY · Cdphp

Other01148NY · Mvp

Other49E991NY · Empire Bluexblue Shield

Medicare PIN55078ANY

Other000401336001NY · Blue Shjeld Of Neny

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 33D0709329

Everett Forman PC · Latham, NY

Active · expires Jul 22, 2027

CLIA Number33D0709329

Laboratory TypePhysician Office

Certificate Effective DateJuly 23, 2025

Certificate Expiration DateJuly 22, 2027

Laboratory DirectorEverett R. Forman MD

Laboratory Phone(518) 785-6004

Laboratory LocationEverett Forman PC585 Troy-Schenectady Road, Latham, NY 12110

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

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

EVERETT ROY FORMAN M.D.

General Practice

585 TROY SCHENECTADY RD
LATHAM, NY 12110

Albany County (518) 785-6004

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 Everett Forman PC's NPI number?

The NPI number for Everett Forman PC is 1144402983. It was assigned to this organization in the NPPES registry on December 4, 2007. The provider is doing business as Medi Scene.

Where is Everett Forman PC located?

Everett Forman PC is located at 585 Troy Schenectady Rd, Latham, NY 12110. The listed phone number is (518) 785-6004.

What is Everett Forman PC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Everett Forman PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 33D0709329) is associated with this NPI, valid through July 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Everett Forman PC was last updated on December 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.