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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PAUL EUGENE FORMAKER D.O.
NPI 1306549753
Student in an Organized Health Care Education/Training Program in Madison, WI

Active since March 24, 2023PECOS Enrolled
600 HIGHLAND AVE, MADISON, WI 53790(608) 263-6400 Get Directions Write a Review

NPPES record last updated: July 3, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Paul Eugene Formaker D.o. NPPES

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

PAUL EUGENE FORMAKER D.O. (NPI 1306549753) is an individual student in an organized health care education/training program in Madison, Wisconsin, licensed in Wisconsin (82140-21) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306549753
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NamePAUL EUGENE FORMAKERCredential: D.O.
Location Address600 HIGHLAND AVEMadison, WI 53790-0001
Mailing Address600 Highland AveMadison, WI 53792-0001 · (608) 263-6400
Phone(608) 263-6400
Sole ProprietorYes
Enumeration DateMarch 24, 2023
Last NPPES UpdateJuly 3, 2026
NPPES CertifiedJuly 3, 2026
✔ NPI 1306549753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in WI · 82140-21
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
600 HIGHLAND AVE, Madison, WI 53790
Open in Google Maps ↗

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paul Eugene Formaker D.o. 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.

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 Paul Formaker's NPI number?

The NPI number for Paul Formaker is 1306549753. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Where is Paul Formaker located?

Paul Formaker practices at 600 Highland Ave, Madison, WI 53790. The listed phone number is (608) 263-6400.

What is Paul Formaker's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Paul Formaker enrolled in Medicare?

Yes. Paul Formaker is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Paul Formaker was last updated on July 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 34 days 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.