Rosha Nicole Forman, CNM - Medicare Advanced Practice Midwife in Boston, MA

  1. Home
  2. Advanced Practice Midwife
  3. MA
  4. Boston
Rosha Nicole Forman, CNM is a medicare enrolled "Advanced Practice Midwife" in Boston, Massachusetts. Her current practice location is 850 Harrison Ave, Yacc 4, Boston, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (617) 414-2000.

Rosha Nicole Forman is licensed to practice in Massachusetts (license number RN271728) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1265683932.

Contact Information

Rosha Nicole Forman, CNM
850 Harrison Ave, Yacc 4,
Boston, MA 02118-4001
(617) 414-2000
(617) 414-5798

Map and Direction




Provider's Profile

Full NameRosha Nicole Forman
GenderFemale
SpecialityAdvanced Practice Midwife
Location850 Harrison Ave, Boston, Massachusetts
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1265683932
  • Provider Enumeration Date: 09/30/2008
  • Last Update Date: 04/29/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6204974108
  • Enrollment ID: I20091113000329

Medical Identifiers

Medical identifiers for Rosha Nicole Forman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265683932NPI-NPPES
110086179AMedicaidMA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 271728 (Massachusetts)Secondary
367A00000XAdvanced Practice Midwife RN271728 (Massachusetts)Primary

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. Rosha Nicole Forman allows following entities to bill medicare on her behalf.
Entity NameDothouse Health Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578514733
PECOS PAC ID: 8729991021
Enrollment ID: O20031112000264
Entity NameCodman Square Health Center, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396808309
PECOS PAC ID: 8123013869
Enrollment ID: O20040420000859
Entity NameBoston University Obstetrics And Gynecology Foundation Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063459568
PECOS PAC ID: 1456323153
Enrollment ID: O20070525000149

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. Rosha Nicole Forman 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 AddressPractice Location Address
Rosha Nicole Forman, CNM
720 Harrison Ave, Dob 503,
Boston, MA 02118-2371

Ph: () -		Rosha Nicole Forman, CNM
850 Harrison Ave, Yacc 4,
Boston, MA 02118-4001

Ph: (617) 414-2000

Reviews and Comments


Advanced Practice Midwife Nurses in Boston, MA

Marie C Henderson, CNM
Advanced Practice Midwife
Medicare: Accepting Medicare Assignments
Practice Location: 55 Fruit Street, Yaw 4, Boston, MA 02114
Phone: 617-724-2229    
Jean Ewan, CNM
Advanced Practice Midwife
Medicare: Not Enrolled in Medicare
Practice Location: 850 Harrison Ave, Yawkey 4th Floor, Boston, MA 02118
Phone: 617-414-2000    Fax: 617-414-5798
Emily Mansur Fox, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 725 Albany St, Fl 5, Shapiro Bldg, Boston, MA 02118
Phone: 617-414-2000    Fax: 617-414-5798
Mrs. Stephanie Marisa Mitchell, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 850 Harrison Ave # Yacc5, Boston, MA 02118
Phone: 617-414-2000    Fax: 617-414-5798
Ms. Dorothy Brewin, CNM
Advanced Practice Midwife
Medicare: Not Enrolled in Medicare
Practice Location: 75 Francis St, Boston, MA 02115
Phone: 617-732-5053    
Ms. Natalia S Richey, CNM, RN
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 55 Fruit St # 4, Boston, MA 02114
Phone: 617-643-6412    
Somphit Chinkam, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 850 Harrison Ave, 5th Fl, Boston, MA 02118
Phone: 617-414-2000    Fax: 617-414-5798

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.