FORM HEALTH ASSOCIATES MA, P.C.
NPI 1386260594
Internal Medicine - Endocrinology, Diabetes & Metabolism in Boston, MA
About Form Health Associates Ma, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FORM HEALTH ASSOCIATES MA, P.C. (NPI 1386260594) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Boston, Massachusetts and active in the NPI registry since June 2020. The organization lists Nam H Kim, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Form Health Associates Ma, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
78Medicare enrollment records show 78 clinicians reassign Medicare billing to Form Health Associates Ma, P.C., which bills Medicare for the services they deliver. Of these, 10 practice at this address. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 7
Nearest to this location (20)
See all 78Philadelphia, PA 19107
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Form Health Associates Ma, P.C.'s NPI number?
The NPI number for Form Health Associates Ma, P.C. is 1386260594. It was assigned to this organization in the NPPES registry on June 23, 2020.
Where is Form Health Associates Ma, P.C. located?
Form Health Associates Ma, P.C. is located at 109 State Street 5th Fl, Boston, MA 02109. The listed phone number is (617) 505-1520.
What is Form Health Associates Ma, P.C.'s specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.
Is Form Health Associates Ma, P.C. enrolled in Medicare?
Yes. Form Health Associates Ma, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Form Health Associates Ma, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 78 clinicians in 7 Medicare specialties reassign their Medicare billing to Form Health Associates Ma, P.C.. A 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 the clinician's services. The largest specialties are Nurse Practitioner (37), Internal Medicine (20) and Family Practice (14). Of these, 10 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Form Health Associates Ma, P.C. accept?
Health plans from Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Texas list Form Health Associates Ma, P.C. 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 Form Health Associates Ma, P.C. was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Form Health Associates Ma, P.c. · NPI 1386260594
Endocrinology, Diabetes & Metabolism organization in Boston, Massachusetts. Organization record, active in the CMS NPPES registry since June 23, 2020.
## Identity
- **NPI:** 1386260594 (Entity type: Organization)
- **Enumerated:** June 23, 2020
- **Primary specialty:** Internal Medicine - Endocrinology, Diabetes & Metabolism · taxonomy 207RE0101X
- **Organization subpart:** No
- **Authorized official:** Nam Kim, PRESIDENT
## Practice location
- **Address:** 109 STATE STREET, 5TH FL, Boston, MA 02109-2906
- **Phone:** (617) 505-1520 · **Fax:** (617) 928-8401
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 78 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (37), Internal Medicine (20), Family Practice (14); 10 practice at this address; [full list](https://npiprofile.com/npi/1386260594/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1386260594) · Data from the CMS NPPES public registry.