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DR. ROBIN B FORMAN ROSE D.O.
NPI 1336287515
Internal Medicine - Gastroenterology in Ridgefield, CT

Active since February 01, 2007Opted out of Medicare · through Jan 25, 2028
38C GROVE ST, RIDGEFIELD, CT 06877(203) 900-4416(203) 666-5649 Get Directions Write a Review

NPPES record last updated: July 8, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 8, 2021, May 10, 2017 (2 updates tracked since 2017).

About Dr. Robin B Forman Rose D.o. NPPES

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

DR. ROBIN B FORMAN ROSE D.O. (NPI 1336287515) is an individual gastroenterology provider in Ridgefield, Connecticut, licensed in Connecticut (45319) and active in the NPI registry since February 2007. She has opted out of Medicare through January 25, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1336287515
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameDR. ROBIN B FORMAN ROSECredential: D.O.
Location Address38C GROVE STRidgefield, CT 06877-4669
Mailing Address38c Grove StRidgefield, CT 06877-4669 · (203) 900-4416 · Fax (203) 666-5649
Phone(203) 900-4416
Fax(203) 666-5649
Sole ProprietorNo
Enumeration DateFebruary 1, 2007
Last NPPES UpdateJuly 8, 20212 updates tracked since enumeration
NPPES CertifiedJuly 8, 2021
✔ NPI 1336287515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in CT · 45319
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
38C GROVE ST, Ridgefield, CT 06877
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Robin B Forman Rose D.o. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 25, 2022 through January 25, 2028.

Opt-Out Effective DateJanuary 25, 2022
Opt-Out In Effect ThroughJanuary 25, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06877 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

Other Providers at the Same Location NPPES

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

JEANETTE WAEGELEIN RDN
Dietitian, Registered
38C GROVE ST
RIDGEFIELD, CT 06877
Western Connecticut Planning Region (203) 900-4416

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 Robin Forman Rose's NPI number?

The NPI number for Robin Forman Rose is 1336287515. It was assigned to this individual provider in the NPPES registry on February 1, 2007.

Where is Robin Forman Rose located?

Robin Forman Rose practices at 38C Grove St, Ridgefield, CT 06877. The listed phone number is (203) 900-4416.

What is Robin Forman Rose's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Robin Forman Rose enrolled in Medicare?

No. Robin Forman Rose has opted out of Medicare through January 25, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Robin Forman Rose was last updated on July 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.