CHARLES FORMAN
NPI 1194145011
Student in an Organized Health Care Education/Training Program in Columbus, OH
About Charles Forman NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHARLES FORMAN (NPI 1194145011) is an individual student in an organized health care education/training program in Columbus, Ohio and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of Ohio University, College Of Osteopathic Medicine (2014).
NPPES Registry Identity
Specialties & Licenses
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
Charles 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 Charles Forman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Columbus, OH 43215
- Reassigned Medicare billing, Ohio enrollment
- 263 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.
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.
COLUMBUS, OH 43210
COLUMBUS, OH 43210
COLUMBUS, OH 43210
COLUMBUS, OH 43210
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 Charles Forman's NPI number?
The NPI number for Charles Forman is 1194145011. It was assigned to this individual provider in the NPPES registry on April 17, 2014.
Where is Charles Forman located?
Charles Forman practices at 1670 Upham Dr, Columbus, OH 43210. The listed phone number is (614) 293-4540.
What is Charles 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 Charles Forman enrolled in Medicare?
Yes. Charles 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 Charles Forman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Charles Forman reassigns Medicare benefits to State Of Ohio Office Of Budget And Management, State Accounting (Columbus, OH). 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 Charles Forman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Charles Forman was last updated on July 1, 2014. 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.
# Charles Forman · NPI 1194145011
Student in an Organized Health Care Education/Training Program provider in Columbus, Ohio. Individual provider, active in the CMS NPPES registry since April 17, 2014.
## Identity
- **NPI:** 1194145011 (Entity type: Individual)
- **Enumerated:** April 17, 2014
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1670 UPHAM DR, Columbus, OH 43210-1250
- **Phone:** (614) 293-4540
## 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:** State Of Ohio Office Of Budget And Management, State Accounting (NPI 1639148638, Columbus, OH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Ohio University, College Of Osteopathic Medicine, class of 2014
## Record status
- **NPPES last updated:** July 1, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1194145011) · Data from the CMS NPPES public registry.