JAVAUNI FORREST (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1124701461

JAVAUNI FORREST (NP) is a healthcare provider. based in Rochester, New York. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 405270 (NY). The NPI Number for JAVAUNI FORREST (NP) is 1124701461

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
JAVAUNI FORREST (NP)
NPI
1124701461
Phone
Not provided
Address
154 SQUAREVIEW LN
Enumeration Date
14 August 2023
Last Update Date
9 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5852757424
Graduation Year
2023 (3 years ago)
PAC ID
5395259089
Group Practice PAC ID
3173420429
Professional Enrollment ID
I20250707000497
Address ID
NY146420001RO601XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

17,004 NURSE PRACTITIONER in NY

Provider Addresses for JAVAUNI FORREST (NP)

  • 154 SQUAREVIEW LN

    ROCHESTER, NY 146261868

    Phone:

    Type: Mailing

  • 601 ELMWOOD AVE

    ROCHESTER, NY 146420001

    Phone: (646) 853-5307

    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: 2025-07-07

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
I20250707000497INurse PractitionerNYTBD

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 14626)

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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: 3173420429View full group profile
NameSpecialtyState
-NY
Internal MedicineNY
P S Y C H I A T R YNY
Family PracticeNY
P S Y C H I A T R YNY
Clinical PsychologistMI
P S Y C H I A T R YNY
-NY
-NY
Nurse PractitionerNY

Reviews

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Frequently asked questions

Can I cross-check JAVAUNI FORREST (NP) using NPI 1124701461?
NPI 1124701461 belongs to JAVAUNI FORREST (NP); compare other details if you need extra assurance.
Is JAVAUNI FORREST (NP) still an active registrant?
JAVAUNI FORREST (NP) carries an active NPI according to the public dataset.
What expertise is attributed to JAVAUNI FORREST (NP)?
JAVAUNI FORREST (NP)'s specialty line reads Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is JAVAUNI FORREST (NP) associated with Rochester?
Public fields place JAVAUNI FORREST (NP) around Rochester, New York. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for JAVAUNI FORREST (NP) is noted as August 14, 2023 where the registry provides it.

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