BONNIE FORMAN
NPI 1770760456
Speech-Language Pathologist in Valley Cottage, NY
About Bonnie Forman NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BONNIE FORMAN (NPI 1770760456) is an individual speech-language pathologist provider in Valley Cottage, New York, licensed in New York (009166-1) and active in the NPI registry since January 2008.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bonnie Forman is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Bonnie Forman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New York, NY 10128
- Reassigned Medicare billing, New York enrollment
- 564 clinicians in this Medicare group
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 Bonnie Forman's NPI number?
The NPI number for Bonnie Forman is 1770760456. It was assigned to this individual provider in the NPPES registry on January 25, 2008.
Where is Bonnie Forman located?
Bonnie Forman practices at 315 Bliss Ln, Valley Cottage, NY 10989. The listed phone number is (516) 851-2957.
What is Bonnie Forman's specialty?
The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.
Is Bonnie Forman enrolled in Medicare?
Yes. Bonnie Forman is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Bonnie Forman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Bonnie Forman reassigns Medicare benefits to Fox Rehabilitation Physical Therapy Services LLC (New York, 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 Bonnie 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 Bonnie Forman was last updated on January 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Bonnie Forman · NPI 1770760456
Speech-Language Pathologist provider in Valley Cottage, New York. Individual provider, active in the CMS NPPES registry since January 25, 2008.
## Identity
- **NPI:** 1770760456 (Entity type: Individual)
- **Enumerated:** January 25, 2008
- **Primary specialty:** Speech-Language Pathologist · taxonomy 235Z00000X
- **State license:** 009166-1 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 315 BLISS LN, Valley Cottage, NY 10989-2421
- **Phone:** (516) 851-2957
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Fox Rehabilitation Physical Therapy Services LLC (NPI 1174560650, New York, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 25, 2008
---
Source: [NPI Profile](https://npiprofile.com/npi/1770760456) · Data from the CMS NPPES public registry.