DR. JACK STEVEN FORMAN DPM
NPI 1639104458
Podiatrist in Flemington, NJ
Active since July 11, 2006
About Dr. Jack Steven Forman Dpm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACK STEVEN FORMAN DPM (NPI 1639104458) is an individual podiatrist in Flemington, New Jersey, licensed in New Jersey (MD01112) and active in the NPI registry since July 2006.
NPPES Registry Identity
NPI1639104458
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. JACK STEVEN FORMANCredential: DPM
Location Address170 STATE ROUTE 31Flemington, NJ 08822-5756
Mailing Address170 State Route 31, Po Box 2207Flemington, NJ 08822-5756 · (908) 788-5317 · Fax (908) 788-0899
Phone(908) 788-5317
Fax(908) 788-0899
Sole ProprietorYes
Enumeration DateJuly 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1639104458 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in NJ · MD01112
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
170 STATE ROUTE 31, Flemington, NJ 08822
Other Identifiers 3
Medicare ID-Type Unspecified115224NJ
Other22-2248976NJ · Commercial Insurers
Medicare UPINT4470NJ
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
Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months
70%263 patients3/55-star benchmark: 100%
Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who were evaluated for proper footwear and sizing
75%261 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
40%822 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%65 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
76%1,622 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
61%292 patients3/55-star benchmark: 95%
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…
25%577 patients2/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,622 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
73%1,622 patients4/55-star benchmark: 79%
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.
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.
Dentist (General Practice)
170 STATE ROUTE 31, D.A. PIPITONE, DMD
FLEMINGTON, NJ 08822
FLEMINGTON, NJ 08822
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 Jack Forman's NPI number?
The NPI number for Jack Forman is 1639104458. It was assigned to this individual provider in the NPPES registry on July 11, 2006.
Where is Jack Forman located?
Jack Forman practices at 170 State Route 31, Flemington, NJ 08822. The listed phone number is (908) 788-5317.
What is Jack Forman's specialty?
The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.
When was this NPI record last updated?
The NPPES record for Jack Forman was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.
