Teresa D Formo, APRN, CNP in Jamestown, ND - Medicare Nurse Practitioner

Teresa D Formo, APRN, CNP is a medicare enrolled "Nurse Practitioner - Family" in Jamestown, North Dakota. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Innovis Health Llc and her current practice location is 2430 20th St Sw, Jamestown, North Dakota. You can reach out to her office (for appointments etc.) via phone at (701) 253-5300.

Teresa D Formo is licensed to practice in North Dakota (license number R23725) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225648736.

Contact Information

	Teresa D Formo, APRN, CNP
	2430 20th St Sw, Jamestown, ND 58401-6201
	(701) 253-5300
	Not Available

Map and Direction

Provider's Profile

Full Name	Teresa D Formo
Gender	Female
Speciality	Nurse Practitioner
Experience	4 Years
Location	2430 20th St Sw, Jamestown, North Dakota
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Teresa D Formo graduated from nursing school in 2020

NPI Data:

NPI Number: 1225648736
Provider Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020

Medicare PECOS Information:

PECOS PAC ID: 6709203904
Enrollment ID: I20200902002898

Medical Identifiers

Medical identifiers for Teresa D Formo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225648736	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R23725 (North Dakota)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Chi Health At Home	Valley city, ND	Home health agency
Essentia Health	Fargo, ND	Hospital
Jamestown Regional Medical Center	Jamestown, ND	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Innovis Health Llc	9931298155	473

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Teresa D Formo allows following entities to bill medicare on her behalf.

Entity Name	Innovis Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215125463 PECOS PAC ID: 9931298155 Enrollment ID: O20071211000158

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Teresa D Formo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Teresa D Formo, APRN, CNP 1702 University Dr S, Fargo, ND 58103-4940 Ph: () -	Teresa D Formo, APRN, CNP 2430 20th St Sw, Jamestown, ND 58401-6201 Ph: (701) 253-5300

Reviews and Comments

Nurse Practitioner Nurses in Jamestown, ND

Mrs. Jessica Rae Gardner, N.P.-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 920 10th St Se, Jamestown, ND 58401 Phone: 701-365-8700 Fax: 701-365-8701
Patricia Richter, FNP, CNM Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2430 20th Swst 8, Jamestown, ND 58401 Phone: 701-952-4787 Fax: 701-952-4786
Todd J. Mcdowell, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2605 Circle Dr, Jamestown, ND 58401 Phone: 701-253-3282 Fax: 701-253-3999
Mrs. Anne Marie Manyango, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2521 Circle Dr, Jamestown, ND 58401 Phone: 701-253-3712 Fax: 701-253-3667
Candida D Hoggarth-baldwin, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2605 Circle Dr, North Dakota State Hospital, Jamestown, ND 58401 Phone: 701-253-3650 Fax: 701-253-3999
Rebecca Lafavor, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 721 1st Ave S Ste A, Jamestown, ND 58401 Phone: 701-368-4380 Fax: 701-540-6818
Amanda S Wiles, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 904 5th Ave Ne, Jamestown, ND 58401 Phone: 701-253-4000

Teresa D Formo, APRN, CNP - Medicare Nurse Practitioner in Jamestown, ND