Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1629002258 Individual Practitioner Male Practitioner

Dr. Bruce David Forman , MD

Internal Medicine • Gallup, NM

Professional Overview & Biography Verified Profile Summary

Dr. Bruce Forman, MD is a registered healthcare professional specializing in Internal Medicine in Gallup, NM. Practice services are available at 516 E. NIZHONI BLVD. under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

516 E. Nizhoni Blvd.
Box 1337

Gallup, NM 873011337

Telephone 5057221000
Fax 5057268557
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Gallup, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.8 Yrs
State Avg: 23.5 Yrs
Regional Practice Density
32 Specialists

Practicing in Gallup, NM (808 Statewide)

Telehealth Adoption Rate
25.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
180 120 $243.00 $78.23
99213 Established patient office or other outpatient visit, typically 15 minutes
148 106 $157.00 $50.81

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License MI 4301044482

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
777344 (AZ)
Medicaid State Provider ID
16531221 (NM)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Johanna Palmgren

Registered Nurse - Administrator

NPI 1003001314
Sandra Skeets , RN

Registered Nurse - Ambulatory Care

NPI 1003009945

Registered Nurse

Jennifer Moore , RN, BSN

Registered Nurse - Medical-Surgical

NPI 1003016460

Registered Nurse, Bachelor of Science in Nursing

Sally Kaufman , RN

Registered Nurse

NPI 1003110537

Registered Nurse

Nancy Davis , RN

Registered Nurse

NPI 1003184201

Registered Nurse

Lorraine Cabrillas , RN

Registered Nurse - Emergency

NPI 1003372004

Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 31, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location October 31, 2011

Registered at 516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 873011337 (Tel: 5057221000)

📍
Updated Business Mailing Address October 31, 2011

Registered at 516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 873011337 (Tel: 5057221000)

👤
Provider Name / Credentials Updated October 31, 2011

Recorded as BRUCE FORMAN, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 31, 2011

Internal Medicine (License #4301044482 in MI)

🟢
Initial NPI Registration & Enumeration July 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629002258
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2006
Last Update: October 31, 2011
Sole Proprietor: No

Mailing Address

516 E. Nizhoni Blvd., Box 1337

Gallup, NM 873011337

Phone: 5057221000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.