ROSHA NICOLE FORMAN CNM
NPI 1265683932
Advanced Practice Midwife in Boston, MA

Q: What is Rosha Forman's NPI number?

The NPI number for Rosha Forman is 1265683932. It was assigned to this individual provider in the NPPES registry on September 30, 2008.

Q: What is Rosha Forman's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Q: When was this NPI record last updated?

The NPPES record for Rosha Forman was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 September 30, 2008PECOS Enrolled

850 HARRISON AVE, YACC 4, BOSTON, MA 02118(617) 414-2000(617) 414-5798 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Rosha Nicole Forman Cnm NPPES

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

ROSHA NICOLE FORMAN CNM (NPI 1265683932) is an individual advanced practice midwife in Boston, Massachusetts, licensed in Massachusetts (RN271728) and active in the NPI registry since September 2008. She is enrolled in Medicare PECOS and maintains a secondary practice location in Dorchester.

NPPES Registry Identity

NPI1265683932

Entity TypeIndividualFemale

Primary Taxonomy367A00000X

Provider Legal NameROSHA NICOLE FORMANCredential: CNM

Location Address850 HARRISON AVE, YACC 4Boston, MA 02118-4001

Mailing Address720 Harrison Ave, Dob 503Boston, MA 02118-2371

Phone(617) 414-2000

Fax(617) 414-5798

Sole ProprietorNo

Enumeration DateSeptember 30, 2008

Last NPPES UpdateApril 29, 2024

NPPES CertifiedApril 29, 2024

✔ NPI 1265683932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367A00000X

License✔ Licensed in MA · RN271728

Definition

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

Also ListedRegistered NurseTaxonomy 163W00000X · License 271728 (MA)

850 HARRISON AVE, Boston, MA 02118

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Secondary Practice Location 1

Location 1637 Washington StDorchester, MA 02124-3510 · Phone (617) 825-9660 · Fax (617) 288-7898

Other Identifiers 1

Medicaid110086179AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Taro Health, WellSense Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rosha Nicole Forman Cnm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Rosha Forman reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Boston University Obstetrics And Gynecology Foundation, Inc.

0.1 mi

Obstetrics & Gynecology

1 BOSTON MEDICAL CTR PL
Boston, MA 02118

Reassigned Medicare billing, Massachusetts enrollment
158 clinicians in this Medicare group

NPI 1063459568 (617) 414-2000

Dothouse Health Inc.

2.2 mi

Community Health

1353 DORCHESTER AVE
Dorchester, MA 02122

Reassigned Medicare billing, Massachusetts enrollment
98 clinicians in this Medicare group

NPI 1578514733 (617) 740-2200

Codman Square Health Center Inc

3.1 mi

Community Health

637 WASHINGTON ST
Dorchester Center, MA 02124

Reassigned Medicare billing, Massachusetts enrollment
91 clinicians in this Medicare group

NPI 1396808309 (617) 825-9660

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02118 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SHEELA S MARU MD

Obstetrics & Gynecology

850 HARRISON AVE, YACC 4
BOSTON, MA 02118

Suffolk County (617) 414-2000

LIDYA H WLASIUK M.D.

Family Medicine

850 HARRISON AVE, YACC 5
BOSTON, MA 02118

Suffolk County (617) 414-2080

DEBORAH A FRANK MD

Pediatrics

850 HARRISON AVE, YACC5
BOSTON, MA 02118

Suffolk County (617) 414-4841

BRIAN R PENTI M.D.

Family Medicine

850 HARRISON AVE, YACC 4
BOSTON, MA 02118

Suffolk County (617) 414-2080

MARY CHIN LICSW

Social Worker (Clinical)

850 HARRISON AVE, DOWLING 9
BOSTON, MA 02118

Suffolk County (617) 414-4672

ADELIZA OLIVERO MD

Psychiatry & Neurology (Psychiatry)

850 HARRISON AVE
BOSTON, MA 02118

Suffolk County (617) 414-5245

JEAN EWAN CNM

Advanced Practice Midwife

850 HARRISON AVE, YAWKEY 4TH FLOOR
BOSTON, MA 02118

Suffolk County (617) 414-2000

DOREEN LINEHAN RN

Registered Nurse

850 HARRISON AVE, DOWLING NORTH, SUITE 5108
BOSTON, MA 02118

Suffolk County (617) 638-7062

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 Rosha Forman's NPI number?

The NPI number for Rosha Forman is 1265683932. It was assigned to this individual provider in the NPPES registry on September 30, 2008.

Where is Rosha Forman located?

Rosha Forman practices at 850 Harrison Ave Yacc 4, Boston, MA 02118. The listed phone number is (617) 414-2000.

What is Rosha Forman's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Is Rosha Forman enrolled in Medicare?

Yes. Rosha Forman is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Rosha Forman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rosha Forman reassigns Medicare benefits to 3 organizations: Boston University Obstetrics And Gynecology Foundation, Inc. (Boston, MA), Dothouse Health Inc. (Dorchester, MA) and Codman Square Health Center Inc (Dorchester Center, MA). Each 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 Rosha Forman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rosha Forman accept?

Health plans from Anthem Blue Cross and Blue Shield, Taro Health and WellSense Health Plan list Rosha 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.

When was this NPI record last updated?

The NPPES record for Rosha Forman was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.