LISE WENDY FORESTAL (MD) – Family Medicine Physician, NPI 1104453711

LISE WENDY FORESTAL (MD) is a healthcare provider. based in Macon, Georgia. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 12173 (GA). The NPI Number for LISE WENDY FORESTAL (MD) is 1104453711

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
LISE WENDY FORESTAL (MD)
NPI
1104453711
Phone
(478) 633-5560
Address
3780 EISENHOWER PARKWAY
Enumeration Date
24 March 2020
Last Update Date
14 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4876335500
Graduation Year
2014 (12 years ago)
PAC ID
4486066289
Group Practice PAC ID
3678477445
Professional Enrollment ID
I20240904000206
Address ID
GA312060800MA3780XPKWY300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,102 FAMILY PRACTICE in GA

Provider Addresses for LISE WENDY FORESTAL (MD)

  • 3780 EISENHOWER PARKWAY

    MACON, GA 31206

    Phone: (478) 633-5560

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $40.

Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Lilly USA, LLC ($40).

Total Amount

$40

General + Research + Ownership

Payments

2

Total payment records

General Amount

$40

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Lilly USA, LLC$40
View all Open Payments →|Open Payments Risk Radar →

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: 2024-09-04

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240904000206IFamily PracticeGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31206)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678477445View full group profile
NameSpecialtyState
Family PracticeGA
Family Practice, Geriatric MedicineGA
Nurse PractitionerGA
Family PracticeGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Family PracticeGA
-GA
Family PracticeGA

Reviews

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Frequently asked questions

What is the standard ID for LISE WENDY FORESTAL (MD) in the U.S.?
In the U.S., LISE WENDY FORESTAL (MD) is identified by NPI 1104453711.
Is LISE WENDY FORESTAL (MD)'s NPI status active today?
Active status means LISE WENDY FORESTAL (MD)'s NPI record is not deactivated in the public file.
How should patients interpret LISE WENDY FORESTAL (MD)'s specialty?
The extract shows Family Medicine Physician for LISE WENDY FORESTAL (MD). Clinical services aligned with this taxonomy classification.
What city is tied to LISE WENDY FORESTAL (MD)?
The directory associates LISE WENDY FORESTAL (MD) with Macon, Georgia. Check all listed addresses for suites or satellite offices.
Can I export LISE WENDY FORESTAL (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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