THERESA VICTORIA FORTY (D.O.) – Emergency Medicine Physician, NPI 1982022976
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,497 EMERGENCY MEDICINE in VA
Provider Addresses for THERESA VICTORIA FORTY (D.O.)
11885 E 12 MILE RD STE 300A
WARREN, MI 480933467
Phone: (586) 582-6630
Fax: (586) 582-6631
Type: Mailing
1900 ELECTRIC RD
SALEM, VA 24153
Phone: (540) 776-4000
Type: Location
11885 E 12 Mile Rd Ste 300A
Warren, MI 480933467
Phone: (586) 582-6630
Fax: (586) 582-6631
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2020-07-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20180814000887 | I | Emergency Medicine | VA | TBD |
| I20200706001018 | I | Emergency Medicine | WV | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 326 | 321 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 269 | 254 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 135 | 134 | $0 |
| 99291 | Critical care, first 30-74 minutes | 86 | 84 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 14 | 14 | $0 |
Insurance plans in this area (ZIP 48093)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | LA | |
| Emergency Medicine | NC | |
| Physician Assistant | VA | |
| Emergency Medicine | NC | |
| Nurse Practitioner | VA | |
| Emergency Medicine | VA | |
| Emergency Medicine, Internal Medicine | VA | |
| - | VA | |
| Emergency Medicine | SC | |
| Family Practice | VA |
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