BRUCE DAVID FORMAN M.D.
NPI 1629002258
Internal Medicine in Gallup, NM
NPI Status: Active since July 10, 2006
Contact Information
516 E. NIZHONI BLVD.
BOX 1337
GALLUP, NM
ZIP 87301
Phone: (505) 722-1000
Fax: (505) 726-8557
- Individual
- Male
- Internal Medicine
About BRUCE FORMAN
This page provides the complete NPI Profile along with additional information for Bruce Forman, an internist established in Gallup, New Mexico with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1629002258 assigned on July 2006. The practitioner's primary taxonomy code is 207R00000X with license number 4301044482 (MI). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1629002258
- Provider Name
- BRUCE DAVID FORMAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 516 E. NIZHONI BLVD. BOX 1337 GALLUP, NM 87301
- Location Phone
- (505) 722-1000
- Location Fax
- (505) 726-8557
- Mailing Address
- 516 E. NIZHONI BLVD. BOX 1337 GALLUP, NM 87301
- Mailing Phone
- (505) 722-1000
- Mailing Fax
- (505) 726-8557
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-10-2006
- Last Update Date
- 10-31-2011
- Code Navigator
An internist like Bruce Forman is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 4301044482
- License State
- MI
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16531221 | MEDICAID (05) | NM | |
| 8HBJ26 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | HSZ002 |
| 8HBW93 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | HSZ197 |
| 8HBJ24 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | HSZ006 |
| 777344 | MEDICAID (05) | AZ | |
| 8HBJ25 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | HSZ001 |
| 8HBJ28 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | HSZ005 |
| A76720 | MEDICARE UPIN (02) | ||
| 8HBJ27 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | HSZ003 |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 2 | 9 | 0 | 0 | 2 | 2 | 5 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 0 | 0 | 4 | 2 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 0 + 0 + 4 + 2 + 1 + 0 + 24 = 52 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 52 = 8 | 8 | ||||||||
The NPI number 1629002258 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1295723963 | MICHAEL LEE ROBINSON CRNA Individual | Nurse Anesthetist, Certified Registered | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1427003953 | MR. DEAN A YANNIAS M.D. Individual | Otolaryngology | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1063467587 | LILY HUGAR MA CCC-A Individual | Audiologist | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1538114731 | MR. GEORGE BRASINIKAS M.D. Individual | Pathology (Clinical Pathology/Laboratory Medicine) | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1003850116 | TIMOTHY L. AMBROSE DDS Individual | Dentist | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1528004736 | ESPERANZA C SANCHEZ MD Individual | Emergency Medicine | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1801832035 | ROBBIE R DANIELS LADAC Individual | Counselor | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1235175464 | DAISY DESCHEENE LPC Individual | Counselor | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1699701821 | DOUGLAS JOHN LINDSEY LMSW, LPCC Individual | Counselor (Professional) | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1871520874 | SARAH WILSON AYCOCK MD Individual | Family Medicine | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1467489567 | ELEANOR J BEGAY PAC Individual | Physician Assistant | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1932136157 | HELENA PLATERO MSW Individual | Social Worker | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1215964440 | SHARNA J SUTHERIN PH.D. Individual | Psychologist | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1215964176 | JOSEPH B STONE PH.D. Individual | Psychologist | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1518995950 | SUSAN A KRZYMOWSKI PA Individual | Physician Assistant | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1194753533 | ALMA JULIA ALFORD MD Individual | Family Medicine | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
| 1396774204 | JONATHAN VILASIER IRALU M.D. Individual | Internal Medicine | 516 E. NIZHONI BLVD. BOX 1337 GALLUP, NM 87301 (505) 722-1000 |
| 1316976012 | JAMES R LISKO M.D. Individual | Internal Medicine | 516 E. NIZHONI BLVD. BOX 1337 GALLUP, NM 87301 (505) 722-1000 |
| 1982634382 | WILLIAM W. KRZYMOWSKI M.D. Individual | Internal Medicine | 516 E. NIZHONI BLVD. BOX 1337 GALLUP, NM 87301 (505) 722-1000 |
| 1790715530 | CHARLOTTE ANN SWINDAL CNM Individual | Advanced Practice Midwife | 516 E. NIZHONI BLVD. GALLUP, NM 87301 (505) 722-1000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629002258, enumerated in the NPI registry as an "individual" on July 10, 2006
The provider is located at 516 E. Nizhoni Blvd. Box 1337 Gallup, Nm 87301 and the phone number is (505) 722-1000
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on July 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.