Mrs Alyssa Rose Marie Formyduval, MS, OTR/L, CSRS - Occupational Therapist in East Chicago, IN

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Mrs Alyssa Rose Marie Formyduval, MS, OTR/L, CSRS is a Occupational Therapist based in East Chicago, Indiana. Mrs Alyssa Rose Marie Formyduval is licensed to practice in Indiana (license number 31005709A) and her current practice location is 4321 Fir St, East Chicago, Indiana. She can be reached at her office (for appointments etc.) via phone at (219) 392-7400.

NPI number for Mrs Alyssa Rose Marie Formyduval is 1891285748 and her current mailing address is 4321 Fir St, East Chicago, Indiana. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1891285748.

Contact Information

Mrs Alyssa Rose Marie Formyduval, MS, OTR/L, CSRS
4321 Fir St,
East Chicago, IN 46312-3097
(219) 392-7400
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMrs Alyssa Rose Marie Formyduval
GenderFemale
SpecialityOccupational Therapist
Location4321 Fir St, East Chicago, Indiana
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1891285748
  • Provider Enumeration Date: 05/16/2018
  • Last Update Date: 05/16/2018

Medical Identifiers

Medical identifiers for Mrs Alyssa Rose Marie Formyduval such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891285748NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 31005709A (Indiana)Primary

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. Mrs Alyssa Rose Marie Formyduval is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Alyssa Rose Marie Formyduval, MS, OTR/L, CSRS
4321 Fir St,
East Chicago, IN 46312-3097

Ph: (219) 392-7400		Mrs Alyssa Rose Marie Formyduval, MS, OTR/L, CSRS
4321 Fir St,
East Chicago, IN 46312-3097

Ph: (219) 392-7400

Reviews and Comments


Occupational Therapist in East Chicago, IN

Alicia Berman, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 4321 Fir St, East Chicago, IN 46312
Phone: 219-836-5381    
Eduardo Valle, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 4321 Fir St Fl 4, East Chicago, IN 46312
Phone: 219-392-7799    

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.