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JOSHUA FORMANECK
NPI 1609523125
Physician Assistant in Newberry, SC

Active since March 04, 2022PECOS EnrolledAccepts Medicare Assignment
70.05/100
CMS Quality Rating
1410 WILSON RD, NEWBERRY, SC 29108(803) 276-2186 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 11, 2024, Mar 4, 2022 (2 updates tracked since 2022).

About Joshua Formaneck NPPES

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

JOSHUA FORMANECK (NPI 1609523125) is an individual physician assistant in Newberry, South Carolina, licensed in South Carolina (PA4217) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1609523125
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJOSHUA FORMANECK
Location Address1410 WILSON RDNewberry, SC 29108-3050
Mailing AddressPo Box 749306Atlanta, GA 30374-9306
Phone(803) 276-2186
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 4, 2022
Last NPPES UpdateNovember 11, 20242 updates tracked since enumeration
NPPES CertifiedNovember 11, 2024
✔ NPI 1609523125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in SC · PA4217
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1410 WILSON RD, Newberry, SC 29108
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next.Insurance ›

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

Joshua Formaneck 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 ID9032596010
PECOS Enrollment IDI20220512001210
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 2

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.
16 services15 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29108 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
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.

70.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality48.22
Promoting Interoperability98
Improvement Activities40
Cost53.62

Other Providers at the Same Location NPPES 6

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

PROGRESSIVE PHYSICAL THERAPY, PA
Physical Therapist
1410 WILSON RD
NEWBERRY, SC 29108
Newberry County (803) 276-2966
RAJENDRA SHRESTHA
Physician Assistant
1410 WILSON RD
NEWBERRY, SC 29108
Newberry County (803) 276-2186
DOCTORS CARE SC, PA
Family Medicine
1410 WILSON RD
NEWBERRY, SC 29108
Newberry County (803) 276-2186
MS. MARNIE VANSTRUM MD
Family Medicine
1410 WILSON RD
NEWBERRY, SC 29108
Newberry County (803) 276-2186
JESSICA CAROLE BLAKE FNP
Nurse Practitioner
1410 WILSON RD
NEWBERRY, SC 29108
Newberry County (803) 276-2186
KELLY ANNE YOUNG FNP-C
Nurse Practitioner (Family)
1410 WILSON RD
NEWBERRY, SC 29108
Newberry County (803) 276-2186

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 Joshua Formaneck's NPI number?

The NPI number for Joshua Formaneck is 1609523125. It was assigned to this individual provider in the NPPES registry on March 4, 2022.

Where is Joshua Formaneck located?

Joshua Formaneck practices at 1410 Wilson Rd, Newberry, SC 29108. The listed phone number is (803) 276-2186.

What is Joshua Formaneck's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Joshua Formaneck enrolled in Medicare?

Yes. Joshua Formaneck 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.

What insurance does Joshua Formaneck accept?

Health plans from First Choice Next list Joshua Formaneck 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 Joshua Formaneck was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.