Form Health Associates, P.c. - Medicare Primary Care in Boston, MA

Form Health Associates, P.c. is a medicare enrolled primary clinic (Internal Medicine - Endocrinology, Diabetes & Metabolism) in Boston, Massachusetts. The current practice location for Form Health Associates, P.c. is 179 Lincoln St Fl 4, Boston, Massachusetts. For appointments, you can reach them via phone at (617) 505-1520. The mailing address for Form Health Associates, P.c. is 179 Lincoln St Ste 404, Boston, Massachusetts and phone number is (617) 505-1520.

Form Health Associates, P.c. is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1043835044. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (617) 505-1520.

Contact Information

Form Health Associates, P.c.
179 Lincoln St Fl 4
Boston
MA 02111-2424
(617) 505-1520
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameForm Health Associates, P.c.
SpecialityInternal Medicine
Location179 Lincoln St Fl 4, Boston, Massachusetts
Authorized Official Name and PositionNam Ho Kim (PRESIDENT)
Authorized Official Contact6175051520
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Form Health Associates, P.c.
179 Lincoln St Ste 404
Boston
MA 02111-2425

Ph: (617) 505-1520
Form Health Associates, P.c.
179 Lincoln St Fl 4
Boston
MA 02111-2424

Ph: (617) 505-1520

NPI Details:

NPI Number1043835044
Provider Enumeration Date06/15/2020
Last Update Date02/24/2022

Medicare PECOS Information:

Medicare PECOS PAC ID0244641272
Medicare Enrollment IDO20201124001275

Medical Identifiers

Medical identifiers for Form Health Associates, P.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043835044NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207RE0101XInternal Medicine - Endocrinology, Diabetes & Metabolism (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Form Health Associates, P.c. acts as a billing entity for following providers:
Provider NameMichelle Cao
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003129842
PECOS PAC ID: 9638328370
Enrollment ID: I20121012000428
Provider NameLauren Marshall Lemieux
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1912393463
PECOS PAC ID: 5799030458
Enrollment ID: I20180620002233
Provider NameNathaniel M Pedley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1669978532
PECOS PAC ID: 4486082898
Enrollment ID: I20210622003552

Reviews and Comments


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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.