NICOLE ANN FORMAN FNP
NPI 1184570533
Nurse Practitioner - Family in Stony Brook, NY
About Nicole Ann Forman Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE ANN FORMAN FNP (NPI 1184570533) is an individual family provider in Stony Brook, New York, licensed in New York (F357935) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS, is affiliated with Suny/stony Brook University Hospital, and is a graduate of Other (2025).
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 and accepts Medicare assignment
Nicole Ann Forman Fnp 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Suny/Stony Brook University Hospital
Acute Care Hospitals · Stony Brook, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
STONY BROOK, NY 11794
STONY BROOK, NY 11794
STONY BROOK, NY 11794
STONY BROOK, NY 11794
STONY BROOK, NY 11794
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 Nicole Forman's NPI number?
The NPI number for Nicole Forman is 1184570533. It was assigned to this individual provider in the NPPES registry on March 9, 2026.
Where is Nicole Forman located?
Nicole Forman practices at 100 Nicolls Rd Hsc 16-047, Stony Brook, NY 11794. The listed phone number is (631) 444-3457.
What is Nicole Forman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Nicole Forman enrolled in Medicare?
Yes. Nicole 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.
Is Nicole Forman affiliated with any hospitals?
According to CMS data, Nicole Forman is affiliated with Suny/Stony Brook University Hospital.
When was this NPI record last updated?
The NPPES record for Nicole Forman was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Nicole Ann Forman, FNP · NPI 1184570533
Family physician in Stony Brook, New York. Individual provider, active in the CMS NPPES registry since March 9, 2026.
## Identity
- **NPI:** 1184570533 (Entity type: Individual)
- **Enumerated:** March 9, 2026
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F357935 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 100 NICOLLS RD, HSC 16-047, Stony Brook, NY 11794
- **Phone:** (631) 444-3457
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** March 9, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1184570533) · Data from the CMS NPPES public registry.