Paul D Forman (NPI# 1871606004, PAC ID# 5294729877) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1871606004 |
| PAC ID by PECOS | 5294729877 |
| Professional Enrollment ID | I20040527000333 |
| Full Name | Paul D Forman |
| Organization Legal Name | MAT-SU VALLEY III LLC |
| Address |
1700 E Bogard Rd Suite 100 Wasilla AK 99654-6563 |
| Phone Number | 9073521300 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1993 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5496941502 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 020006 | MAT-SU REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1700 E Bogard Rd, Suite 100, Wasilla, AK 99654-6563 | 9073521300 | MAT-SU VALLEY III LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_331_overall | Adult Sinusitis: Antibiotic Prescribed for Acute Sinusitis (Overuse) (100%: worst, 0% best) | 91% | |
| MIPS_EC_333_overall | Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse) (100%: worst, 0% best) | 0% |
| Organization Legal Name | MAT-SU VALLEY III LLC |
| Physicians | 21 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin Eachon | Physician Assistant | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Virginia C Cooper | Physician Assistant | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Shawn A Roberts | Nurse Practitioner | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Paul H Gibson | Physician Assistant | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Michael A Dibartolo | Family Medicine | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Barbara J Doty | Family Medicine | Mat-su Valley IIi LLC | 1700 E Bogard Rd, Suite 100, Wasilla, AK 99654-6563 |
| Matthew John Mau | Physician Assistant | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Jessica D Rowley | Physician Assistant | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Megan Ferguson | Certified Nurse Midwife (cnm) | Mat-su Valley IIi LLC | 2490 S Woodworth Loop, Suite 301, Palmer, AK 99645-7407 |
| Violeta D Yeager | Nurse Practitioner | Mat-su Valley IIi LLC | 209 W Evergreen Ave, Palmer, AK 99645-6952 |
| Street Address |
1700 E BOGARD RD SUITE 100 |
| City | WASILLA |
| State | AK |
| Zip | 99654-6563 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kyle Victor Mills | Physical Therapy | Excel Physical Therapy Limited Partnership | 1700 E Bogard Rd, Bldg B, Wasilla, AK 99654-6563 |
| Jacob Burtch | Physical Therapy | Excel Physical Therapy Limited Partnership | 1700 E Bogard Rd, Bldg B, Wasilla, AK 99654-6563 |
| Casey Michael Buckland | Physical Therapy | Excel Physical Therapy Limited Partnership | 1700 E Bogard Rd, Bldg B, Wasilla, AK 99654-6563 |
| Barbara J Doty | Family Medicine | Mat-su Valley IIi LLC | 1700 E Bogard Rd, Suite 100, Wasilla, AK 99654-6563 |
| Tucker A Drury | Orthopedic Surgery | Orthoalaska LLC | 1700 E Bogard Rd, Suite 102, Wasilla, AK 99654-6563 |
| Valerie K Krozel | Family Medicine | Mat-su Valley IIi LLC | 1700 E Bogard Rd, Suite 100, Wasilla, AK 99654-6563 |
| Myra Dimitrov | Family Practice | Mat-su Valley IIi LLC | 1700 E Bogard Rd, Suite 100, Wasilla, AK 99654-6563 |
| Katherine Anna Hunter | Physical Therapy | Excel Physical Therapy Limited Partnership | 1700 E Bogard Rd, Bldg B, Wasilla, AK 99654-6563 |
| Tell Suckut | Physical Therapy | Excel Physical Therapy Limited Partnership | 1700 E Bogard Rd, Bldg B, Wasilla, AK 99654-6563 |
| Sundi M Hondl | Physical Therapy | Excel Physical Therapy Limited Partnership | 1700 E Bogard Rd, Bldg B, Wasilla, AK 99654-6563 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blaine G Upham | Chiropractic | 5461 E Mayflower Lane, Suite 6, Wasilla, AK 99654 | |
| Jeffrey A Lepage | Physical Therapy | First Choice Physical Therapy Inc | 6701 W Blondell St, Wasilla, AK 99654 |
| Trisha M Magee | Physical Therapy | Health Quest Therapy Inc | Mile 4, Wasilla, AK 99654 |
| Marlys F Bryan | Physical Therapy | Health Quest Therapy Inc | Mile 4, Wasilla, AK 99654 |
| Josh T Williams | Physical Therapy | First Choice Physical Therapy Inc | 6701 W Blondell St, Wasilla, AK 99654 |
| Amy L Stielstra | Physical Therapy | First Choice Physical Therapy Inc | 6701 W Blondell St, Wasilla, AK 99654 |
| Corissa J Abel | Physical Therapy | First Choice Physical Therapy Inc | 6701 W Blondell St, Wasilla, AK 99654 |
| Lisa M Bouyea-francies | Nurse Practitioner | Mat-su Health Services Inc. | 1363 W Spruce Ave, Wasilla, AK 99654-5327 |
| Robin Hughes | Clinical Social Worker | Mat-su Health Services Inc. | 1363 W Spruce Ave, Wasilla, AK 99654-5327 |
| Mary A Eckart | Physician Assistant | Mat-su Health Services Inc. | 1363 W Spruce Ave, Wasilla, AK 99654-5327 |
| Find all physicians in zip 99654 | |||
| City | WASILLA |
| Zip Code | 99654 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | WASILLA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Paul D Forman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.