PAUL FORMAN (MD) – Family Medicine Physician, NPI 1871606004
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
495 FAMILY PRACTICE in AK
Provider Addresses for PAUL FORMAN (MD)
950 E BOGARD RD STE 233
WASILLA, AK 996547185
Phone: (907) 352-1300
Fax: (907) 352-1310
Type: Location
34300 TALKEETNA S SPUR RD
TALKEETNA, AK 99676
Phone: (907) 733-2273
Fax: (907) 733-1735
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $505.
Total Amount is formed as General ($505) + Research ($0) + Ownership ($0) = $505.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: ABBVIE INC. ($265).
Total Amount
$505
General + Research + Ownership
Payments
22
Total payment records
General Amount
$505
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-05-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040527000333 | I | Family Practice | AK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 43 | 38 | $0 |
| 83036 | Hemoglobin a1c level | 43 | 34 | $0 |
| 81000 | Manual urinalysis test with examination using microscope, non-automated | 20 | 11 | $0 |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 17 | 12 | $0 |
| 82570 | Creatinine level to test for kidney function or muscle injury | 14 | 14 | $0 |
Insurance plans in this area (ZIP 99654)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | AK | 81002 | Urinalysis, manual test | 29 | 20 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AK | |
| - | AK | |
| Clinical Social Worker | AK | |
| Internal Medicine | AZ | |
| Physician Assistant | AK | |
| Physician Assistant | AK | |
| Physician Assistant | AK | |
| Nurse Practitioner | AK | |
| Physician Assistant | AK |
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