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WAYNE FORMAN O.D.
NPI 1780695015
Optometrist in Carmel, NY

Active since August 11, 2006PECOS Enrolled
664 STONELEIGH AVE, CARMEL, NY 10512(845) 279-2000(845) 279-7730 Get Directions Write a Review

NPPES record last updated: November 16, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Wayne Forman O.d. NPPES

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

WAYNE FORMAN O.D. (NPI 1780695015) is an individual optometrist in Carmel, New York, licensed in New York (T003976) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780695015
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameWAYNE FORMANCredential: O.D.
Location Address664 STONELEIGH AVECarmel, NY 10512-3940
Mailing Address110 S Bedford Rd, Caremount Medical PcMount Kisco, NY 10549-3446 · (914) 241-1050 · Fax (914) 242-1516
Phone(845) 279-2000
Fax(845) 279-7730
Sole ProprietorNo
Enumeration DateAugust 11, 2006
Last NPPES UpdateNovember 16, 2016
✔ NPI 1780695015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in NY · T003976
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
664 STONELEIGH AVE, Carmel, NY 10512
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Other Identifiers 3

Medicare PINA400014006NY
Medicare UPINOTH00NY
Medicare PIN533H24NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wayne Forman O.d. 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 Wayne Forman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Optum Medical Care, P.C.
13 mi
Cardiovascular Disease
90 SOUTH BEDFORD RD, MT KISCO MEDICAL GROUP PC
Mount Kisco, NY 10549
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Optum Medical Care PC
  • 1,601 clinicians in this Medicare group
NPI 1982643003 (914) 241-1050

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
404 services399 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
55 services55 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
52 services51 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
46 services45 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.
46 services39 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
34 services34 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10512 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
$141.77 typical visit price
range $61.88 – $187.05
Typical copayment $35.44 (range $15.47 – $46.76)
Most-billed visit code 99204
Established Patient
$76.88 typical visit price
range $19.92 – $151.94
Typical copayment $19.22 (range $4.98 – $37.98)
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.

Other Providers at the Same Location NPPES 20

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

SANIA SAEED MD
Student in an Organized Health Care Education/Training Program
664 STONELEIGH AVE
CARMEL, NY 10512
Putnam County (203) 241-6495
DR. YARIV MAGHEN M.D.
Orthopaedic Surgery
664 STONELEIGH AVE, SUITE 300
CARMEL, NY 10512
Putnam County (845) 278-8400
LINDA MANDL STOCKER CNM
Midwife
664 STONELEIGH AVE, SUITE 201
CARMEL, NY 10512
Putnam County (845) 231-5600
DANIEL AKINTUNDE OLAYIWOLA MD
Student in an Organized Health Care Education/Training Program
664 STONELEIGH AVE
CARMEL, NY 10512
Putnam County (845) 790-1321
LAURA KLEIN FNP
Nurse Practitioner (Family)
664 STONELEIGH AVE, STE 300
CARMEL, NY 10512
Putnam County (845) 230-5161
JOEL S BUCHALTER MD
Orthopaedic Surgery
664 STONELEIGH AVE, STE 300 SOMERS ORTHOPAEDIC SURGERY AND SPORTS MED GR PL
CARMEL, NY 10512
Putnam County (845) 278-8400
KIRSI ELISE VERA PT
Physical Therapist
664 STONELEIGH AVE
CARMEL, NY 10512
Putnam County (845) 279-1785
SABRINA MARIS DIAZ MD
Student in an Organized Health Care Education/Training Program
664 STONELEIGH AVE
CARMEL, NY 10512
Putnam County (845) 790-1321

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 Wayne Forman's NPI number?

The NPI number for Wayne Forman is 1780695015. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Where is Wayne Forman located?

Wayne Forman practices at 664 Stoneleigh Ave, Carmel, NY 10512. The listed phone number is (845) 279-2000.

What is Wayne Forman's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Wayne Forman enrolled in Medicare?

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

Which organization bills Medicare for Wayne Forman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Wayne Forman reassigns Medicare benefits to Optum Medical Care, P.C. (Mount Kisco, 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 Wayne 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 Wayne Forman was last updated on November 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.