Active NPI 1528061967 Individual Practitioner Male Practitioner

Dr. Everett Roy Forman , MD

General Practice • Latham, NY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Everett Forman, MD is a certified General Practice practicing in Latham, NY. With approximately 58 years of clinical experience since graduating from Albany Medical College Of Union University in 1968, Dr. Forman delivers high-quality medical care to the local community at 585 TROY SCHENECTADY RD.

Dr. Forman accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, urinalysis, manual test. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

585 Troy Schenectady Rd

Latham, NY 121102811

Telephone 5187856004

Fax 5187851702

Associated Practice Facility / Clinic

🏢 Everett Forman Pc Facility NPI 1144402983

Medicare Profile & Education

Medical School

Albany Medical College Of Union University

Graduation Year

1968

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Latham, NY

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

58 Yrs Matches City Avg

City Avg: 58.0 Yrs

State Avg: 30.3 Yrs

Regional Practice Density

1 Specialists

Practicing in Latham, NY (818 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

47.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Forman (58 Years) 58 Yrs

Latham Specialty Average (58.0 Years) 58.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	164	84	$110.00	$83.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	99	63	$140.00	$119.88
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	13	13	$375.00	$122.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	132	73	$110.00	$81.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	110	68	$140.00	$122.37
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	11	$200.00	$171.94

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	160	80	$140.00	$124.71
99213 Established patient office or other outpatient visit, typically 15 minutes	123	69	$110.00	$84.07
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	19	19	$375.00	$127.23
81002 Urinalysis, manual test	17	11	$22.00	$3.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	115	70	$110.00	$89.19
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	90	48	$98.00	$53.63
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	60	43	$140.00	$127.32
99442 Telephone medical discussion with physician, 11-20 minutes	23	20	$110.00	$89.90
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	14	14	$375.00	$129.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	232	95	$110.00	$72.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	61	46	$140.00	$105.98
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	56	37	$98.00	$42.57
99441 Telephone medical discussion with physician, 5-10 minutes	41	25	$110.00	$44.31
99442 Telephone medical discussion with physician, 11-20 minutes	16	15	$110.00	$73.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	276	111	$110.00	$68.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	174	80	$140.00	$101.15
82985 Glycated protein level	39	20	$46.00	$16.42
G0008 Administration of influenza virus vaccine	29	29	$70.00	$15.94
90756 Vaccine for influenza for injection into muscle	29	29	$45.00	$26.13
80061 Blood test, lipids (cholesterol and triglycerides)	27	15	$85.00	$14.58
82947 Blood glucose (sugar) level	22	13	$22.00	$4.28
81002 Urinalysis, manual test	20	13	$22.00	$3.41
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	12	12	$375.00	$106.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	302	119	$110.00	$66.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	190	91	$140.00	$97.53
82985 Glycated protein level	48	22	$46.00	$18.24
80061 Blood test, lipids (cholesterol and triglycerides)	43	20	$85.00	$16.20
82947 Blood glucose (sugar) level	42	19	$22.00	$4.75
G0008 Administration of influenza virus vaccine	34	34	$70.00	$19.61
Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)	31	31	$45.00	$17.34
81002 Urinalysis, manual test	19	16	$22.00	$3.41
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	15	15	$375.00	$105.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	340	115	$110.00	$65.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	190	93	$140.00	$96.35
82985 Glycated protein level	39	20	$46.00	$20.27
82947 Blood glucose (sugar) level	37	19	$22.00	$4.74
G0008 Administration of influenza virus vaccine	34	34	$70.00	$24.23
80061 Blood test, lipids (cholesterol and triglycerides)	33	21	$85.00	$16.82
Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)	32	32	$45.00	$17.34
81002 Urinalysis, manual test	23	15	$22.00	$3.43
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	11	11	$375.00	$103.55

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License NY 103928-1

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Cdphp

10000672

Commercial Insurance / Payer ID Mvp

01148

Commercial Insurance / Payer ID Blue Shield Of Neny

000401336001

Commercial Insurance / Payer ID Empire Bcbs

49E991

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 585 TROY SCHENECTADY RD, LATHAM, NY 121102811 (Tel: 5187856004)

📍

Updated Business Mailing Address July 08, 2007

Registered at 47 SWEET RD, BALLSTON LAKE, NY 120191805 (Tel: 5187856004)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as EVERETT FORMAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

General Practice (License #103928-1 in NY)

🟢

Initial NPI Registration & Enumeration May 31, 2005

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: 1528061967

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 31, 2005

Last Update: July 08, 2007

Sole Proprietor: No

Update or Correct Profile

Mailing Address

47 Sweet Rd

Ballston Lake, NY 120191805

Phone: 5187856004

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.