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MELANIE GAY FORMAN ANP
NPI 1578815015
Nurse Practitioner - Adult Health in Cedarhurst, NY

Active since October 08, 2012PECOS Enrolled
558 ARLINGTON PL, CEDARHURST, NY 11516(516) 444-9940 Get Directions Write a Review

NPPES record last updated: January 6, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Melanie Gay Forman Anp NPPES

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

MELANIE GAY FORMAN ANP (NPI 1578815015) is an individual adult health provider in Cedarhurst, New York, licensed in New York (F304843-1) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578815015
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMELANIE GAY FORMANCredential: ANP
Location Address558 ARLINGTON PLCedarhurst, NY 11516-1006
Mailing Address1618 Park StAtlantic Beach, NY 11509-1520 · (516) 451-9355
Phone(516) 444-9940
Sole ProprietorYes
Enumeration DateOctober 8, 2012
Last NPPES UpdateJanuary 6, 2016
✔ NPI 1578815015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · F304843-1
558 ARLINGTON PL, Cedarhurst, NY 11516
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Melanie Gay Forman Anp 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 Reassignment

Medicare enrollment records show Melanie Forman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Brookview Medical Associates, PLLC
35 mi
General Practice
80 ORVILLE DR STE 100
Bohemia, NY 11716
  • Reassigned Medicare billing, New York enrollment
  • 754 clinicians in this Medicare group
NPI 1871965855 (972) 715-3800

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 11516 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Melanie Forman's NPI number?

The NPI number for Melanie Forman is 1578815015. It was assigned to this individual provider in the NPPES registry on October 8, 2012.

Where is Melanie Forman located?

Melanie Forman practices at 558 Arlington Pl, Cedarhurst, NY 11516. The listed phone number is (516) 444-9940.

What is Melanie Forman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Melanie Forman enrolled in Medicare?

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

Which organization bills Medicare for Melanie Forman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melanie Forman reassigns Medicare benefits to Brookview Medical Associates, PLLC (Bohemia, NY). The 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 Melanie Forman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Melanie Forman was last updated on January 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.