NICOLE ELIZABETH FORBORD (PA) – Physician Assistant, NPI 1063921781

NICOLE ELIZABETH FORBORD (PA) is a healthcare provider. based in Seattle, Washington. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 4293-23 (WI). The NPI Number for NICOLE ELIZABETH FORBORD (PA) is 1063921781

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE ELIZABETH FORBORD (PA)
NPI
1063921781
Phone
(503) 684-8252
Address
531 Broadway E Ste 10
Enumeration Date
26 September 2017
Last Update Date
11 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4146475000
Graduation Year
2017 (9 years ago)
PAC ID
8820355522
Group Practice PAC ID
8729975461
Professional Enrollment ID
I20180215000216
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

Provider Addresses for NICOLE ELIZABETH FORBORD (PA)

  • 531 Broadway E Ste 10

    Seattle, WA 981025023

    Phone: (503) 684-8252

    Type: Location

  • Community Tire Sales & Service, 102, West North Avenue, Brewers Hill, Milwaukee, Milwaukee County, Wisconsin, 53212, United States

    MILWAUKEE, WI 532262315

    Phone: (414) 877-5350

    Fax: (414) 877-5360

    Type: Mailing

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: 2021-09-08

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
I20210908003513IPhysician AssistantWATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making5757$0
99285Emergency department visit with high level of medical decision making3232$0
99283Emergency department visit with low level of medical decision making1313$0
View full utilization report →

Insurance plans in this area (ZIP 98102)

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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: 8729975461View full group profile
NameSpecialtyState
Emergency MedicineWI
Physician AssistantWI
Emergency MedicineWI
Emergency MedicineWI
Emergency MedicineWI
Physician AssistantWI
Emergency MedicineMN
-WI
Physician AssistantWI
Emergency MedicineWI

Reviews

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Frequently asked questions

What is the registry number for NICOLE ELIZABETH FORBORD (PA)?
The registry entry for NICOLE ELIZABETH FORBORD (PA) shows NPI 1063921781.
Should I treat NICOLE ELIZABETH FORBORD (PA) as an active provider?
Patients and plans typically see NICOLE ELIZABETH FORBORD (PA) as active in the national extract.
What does the directory say NICOLE ELIZABETH FORBORD (PA) does?
Insurance directories may phrase it differently, but here NICOLE ELIZABETH FORBORD (PA) maps to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is NICOLE ELIZABETH FORBORD (PA) tied to Seattle, Washington?
If you are local to Seattle, Washington, NICOLE ELIZABETH FORBORD (PA) may be relevant to your search.
Can I export NICOLE ELIZABETH FORBORD (PA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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