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SVETLANA FOMIN MD
NPI 1326219924
Internal Medicine - Endocrinology, Diabetes & Metabolism in Phillipsburg, NJ

Active since March 21, 2008PECOS EnrolledAccepts Medicare Assignment
755 MEMORIAL PKWY STE 302A, PHILLIPSBURG, NJ 08865(484) 526-7300(866) 449-5832 Get Directions Write a Review

NPPES record last updated: May 1, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 1, 2026, Sep 2, 2025, Apr 11, 2025 and 2 more (5 updates tracked since 2021).

About Svetlana Fomin Md NPPES

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

SVETLANA FOMIN MD (NPI 1326219924) is an individual endocrinology, diabetes & metabolism provider in Phillipsburg, New Jersey, licensed in New York (309596) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS, is affiliated with St Luke's Warren Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1326219924
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameSVETLANA FOMINCredential: MD
Location Address755 MEMORIAL PKWY STE 302APhillipsburg, NJ 08865-2771
Mailing Address113 Austin StTinton Falls, NJ 07712-7760 · (732) 685-1566
Phone(484) 526-7300
Fax(866) 449-5832
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateMarch 21, 2008
Last NPPES UpdateMay 1, 20265 updates tracked since enumeration
NPPES CertifiedMay 1, 2026
✔ NPI 1326219924 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Licenses✔ Licensed in NY · 309596✔ Licensed in NJ · 25MA08122400✔ Licensed in PA · MD488252
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
755 MEMORIAL PKWY STE 302A, Phillipsburg, NJ 08865
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Secondary Practice Locations 2

Location 12591 Baglyos Cir Ste C49Bethlehem, PA 18020-8058 · Phone (484) 503-7300
Location 2193 US Highway 9 Ste 1Manalapan, NJ 07726-3015 · Phone (732) 903-4005 · Fax (616) 226-4685

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

Svetlana Fomin Md 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.

PECOS PAC ID4981770591
PECOS Enrollment IDI20080905000252, I20210507000555, I20251007000896
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
106 services73 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
93 services93 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
67 services33 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
18 services17 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Luke's Warren Hospital

Acute Care Hospitals · Phillipsburg, NJ
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310060
Location185 Roseberry StPhillipsburg, NJ 08865 · Warren County
Emergency services

St Luke's Hospital Bethlehem

Acute Care Hospitals · Bethlehem, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390049
Location801 Ostrum StreetBethlehem, PA 18015 · Northampton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08865 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%467 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%527 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
32 suppliers53 claims221 services$6.57 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
17 suppliers24 claims41 services$1.16 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
10 suppliers138 claims140 services$184.62 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Internal Medicine (Endocrinology, Diabetes & Metabolism)
755 MEMORIAL PKWY STE 302A
PHILLIPSBURG, NJ 08865
Warren County (484) 526-7300
DR. ISHITA SINGH M.B.B.S.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
755 MEMORIAL PKWY STE 302A
PHILLIPSBURG, NJ 08865
Warren County (484) 526-7300
MARYANN MOYLAN RD
Dietitian, Registered
755 MEMORIAL PKWY STE 302A
PHILLIPSBURG, NJ 08865
Warren County (908) 847-2050
EMILY MEYERS CRNP
Nurse Practitioner
755 MEMORIAL PKWY STE 302A
PHILLIPSBURG, NJ 08865
Warren County (908) 847-2050

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 Svetlana Fomin's NPI number?

The NPI number for Svetlana Fomin is 1326219924. It was assigned to this individual provider in the NPPES registry on March 21, 2008.

Where is Svetlana Fomin located?

Svetlana Fomin practices at 755 Memorial Pkwy Ste 302A, Phillipsburg, NJ 08865. The listed phone number is (484) 526-7300.

What is Svetlana Fomin's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Svetlana Fomin enrolled in Medicare?

Yes. Svetlana Fomin 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 Svetlana Fomin affiliated with any hospitals?

According to CMS data, Svetlana Fomin is affiliated with St Luke's Warren Hospital and St Luke's Hospital Bethlehem.

When was this NPI record last updated?

The NPPES record for Svetlana Fomin was last updated on May 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.