JOHN M FORMAN (MD) – Vascular Surgery Physician, NPI 1992871123
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
29 CARDIAC SURGERY in KS
Provider Addresses for JOHN M FORMAN (MD)
1000 CARONDELET, ATTN: PHYSICIAN CREDENTIALING
KANSAS CITY, MO 641144608
Phone: (816) 943-5743
Type: Mailing
8929 Parallel Pkwy
Kansas City, KS 661121689
Phone: (913) 596-4000
Type: Location
3200 NE Ralph Powell Rd
Lees Summit, MO 64064
Phone: (816) 525-1600
Fax: (816) 525-0173
Type: Location
1000 CARONDELET DR STE 201B
KANSAS CITY, MO 641144673
Phone: (816) 943-7600
Fax: (816) 941-7456
Type: Mailing
Saint Joseph Medical Center, 1000, Carondelet Drive, Dallas, Kansas City, Jackson County, Missouri, 64114, United States
STE 201B
KANSAS CITY, MO 64114
Phone: (816) 943-7600
Fax: (816) 941-7456
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $143.
Total Amount is formed as General ($143) + Research ($0) + Ownership ($0) = $143.
Last reported payment date: 2023-11-15 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($83).
Total Amount
$143
General + Research + Ownership
Payments
8
Total payment records
General Amount
$143
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-15
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: 2008-08-12
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 |
|---|---|---|---|---|
| I20031212000220 | I | Thoracic Surgery | MO | TBD |
| I20080812000067 | I | Cardiac Surgery | KS | 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 |
|---|---|---|---|---|
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 22 | 21 | $0 |
Insurance plans in this area (ZIP 64114)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | AZ | |
| Emergency Medicine, Undersea And Hyperbaric Medicine | MO | |
| Nurse Practitioner | KS | |
| Cardiovascular Disease (Cardiology), Nuclear Medicine | MO | |
| - | MO | |
| Internal Medicine, Hospitalist | KS | |
| Nurse Practitioner | MO | |
| - | MO | |
| Cardiovascular Disease (Cardiology), Internal Medicine | MO | |
| - | MO |
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