CASEY FORMAN – Physician Assistant, NPI 1750055307
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in VA
Provider Addresses for CASEY FORMAN
352 W NORTHFIELD BLVD STE 3
MURFREESBORO, TN 371291539
Phone: (844) 893-0012
Type: Mailing
1501 MAPLE AVE STE 206
RICHMOND, VA 232262553
Phone: (844) 893-0012
Type: Location
5875 BREMO RD
STE 601
RICHMOND, VA 232261928
Phone:
Type: Mailing
100 OVALTINE CT UNIT 124
VILLA PARK, IL 601812779
Phone: (516) 457-3349
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 131 Open Payments records for all available years, with a total value of $3,066.
Total Amount is formed as General ($3,066) + Research ($0) + Ownership ($0) = $3,066.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: ABBVIE INC. ($852).
Total Amount
$3,066
General + Research + Ownership
Payments
131
Total payment records
General Amount
$3,066
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
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: 2022-03-25
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 |
|---|---|---|---|---|
| I20220325000043 | I | Physician Assistant | VA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 155 | 123 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 108 | 108 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 41 | 32 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 15 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 37129)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | VA | |
| G A S T R O E N T E R O L O G Y | VA | |
| Physician Assistant | TN | |
| P A T H O L O G Y | VA | |
| G A S T R O E N T E R O L O G Y | VA | |
| Nurse Practitioner | VA | |
| Gastroenterology, Internal Medicine | VA | |
| G A S T R O E N T E R O L O G Y | VA | |
| Physician Assistant | VA | |
| G A S T R O E N T E R O L O G Y | VA |
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